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Precis Future Med > Epub ahead of print
DOI: https://doi.org/10.23838/pfm.2018.00086    [Epub ahead of print]
Published online September 14, 2018.
Silent brain infarction: a quiet predictor of future stroke
Oh Young Bang1,2 
1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Translational and Stem Cell Research Laboratory on Stroke, Samsung Medical Center, Seoul, Korea
Correspondence  Oh Young Bang ,Tel: +82-2-3410-3599, Email: ohyoung.bang@samsung.com
Submitted: July 16, 2018  Accepted after revision: August 1, 2018
Abstract
A silent brain infarct (SBI) is defined as imaging or neuropathological evidence of brain infarction without a history of acute neurological dysfunction attributable to the lesion. The number of patients with SBIs is estimated as several-fold higher than the number with clinical stroke. In addition, SBIs have important clinical implications. The presence of SBIs more than doubles the risk of subsequent stroke and dementia. Although most SBIs are lacunes, for which hypertensive small vessel disease is thought to be the main cause, some of them could be embolic in origin. The pathological mechanisms of SBIs and most effective strategies for prevention of future stroke may differ depending on the cause of the SBI. The literature reviewed and cases presented herein underscore the need for application of appropriate workups and therapeutic strategies in patients with SBIs. In this review, the definition, causes, and clinical impact of SBIs are discussed, together with the questions that remain open and recent advances (e.g., machine learning techniques) in the study of SBIs.
Keywords: Brain ischemia; Etiology; Silent brain infarction; Stroke; Stroke subtype
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