The study of risk factors associated with silent brain infarctions on Magnetic resonance imaging

Abstract

Background: Silent brain infarction (SBI) indicates brain lesion resulted of vascular occlusion without symptom. However, it is considered a predecessor of symptomatic stroke and progressive brain damage subsequent in vascular dementia. Cardiovascular risk factors, such as arterial hypertension, diabetes mellitus, smoking, hyperlipidemia and ischemic heart disease may increase the risk of SBI. Aim: This study was designed to evaluate the risk factors of SBI in a neurologically normal adult population. Materials and Methods: We divided 105 neurologically normal adults (mean age 54.28±10.04, men: women=35:70) who underwent brain magnetic resonance imaging (MRI) at the First Central Hospital in two groups (Silent infarction and Controls) and risk factors of SBI were assessed by interview, clinical examination and laboratory test. Pearson’s chisquare test and two-sample t-test for univariate analysis and multiple logistic regressions for multivariate analysis were performed to evaluate risk factors of SBI for analysis. Results: A total of 395 SBI lesions were observed in 45 subjects. 345 lesions were 1 cm in diameter, 48 were between 1 and 2 cm, 2 were between 2 and 3 cm in diameter. The most frequent site of the SBI lesion was basal ganglia, after which the periventricular white matter, cerebral cortex, thalamus and cerebellum were the most frequent sites. Advanced age, arterial hypertension (OR 4.01, CI 95%, 1.76-9.01, р=0.001), a history of coronary artery disease (OR 7.31, CI 95%, 1.836.51, р=0.051), and high fasting glucose, hemoglobin (HbA1c) levels were associated with SBI on univariate analysis. Multivariate analysis demonstrated family history of cardiovascular disease (OR 2.55, CI 95%, 1.38-6.74, р=0.049) to be independent risk factors for SBI, and mild alcohol consumption was revealed as an independent protective factor against SBI. Conclusion: Advanced age, arterial hypertension and family history of cardiovascular disease are associated with SBI.