Recurrent silent cerebral embolism

Implications of silent strokes

"Silent strokes" or "subclinical strokes" refer to incidental findings of strokes on neuroimaging studies, such as computed tomography or magnetic resonance imaging/diffusion-weighted imaging, that are asymptomatic. These include lacunar and other ischemic strokes and minor hemorrhages, particularly in "silent areas" of the brain, but also include leukoaraiosis due to small vessel pathology of a variety of origins. Clinicians need to appreciate their significance because with certain conditions, such as atrial fibrillation and significant carotid stenosis, follow-up of these patients shows an increased incidence of strokes, impaired cognitive function, and dementia. These serious consequences of subclinical strokes require the clinician to be vigilant and institute preventive strategies to avert these untoward outcomes.

Silent stroke: pathogenesis, genetic factors and clinical implications as a risk factor

Silent stroke is frequently recognized in elderly persons. Diffusion-weighted magnetic resonance imaging has proved to be highly sensitive in the detection of recent silent stroke, and may further applications in the future. Silent stroke in healthy and asymptomatic individuals mainly comprises lacunar infarcts, which are often associated with white matter changes. Thus, analyses of risk factors and genetic factors in small-vessel diseases such as lacunar infarct and white matter changes may provide clues regarding the pathogenesis of silent stroke. Silent stroke may be a risk factor for clinical stroke and cognitive impairment, but prospective studies are required to confirm this.