• The Journal of the Korean life insurance medical association
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• v.28 no.1_2
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• pp.11-14
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• 2009

It is common to find cerebral infarct and hemorrhage without definite neurologic signs but with lesions on neuroimaging. These lesions are called silent lacunar infarct and cerebral microbleed. Silent lacunar infarct are frequently seen in the elderly and are associated with clinically apparent stroke and vascular dementia. Known stroke risk factors, such as hypertension, diabetes mellitus, smoking, hypercholesterolemia and heart problems may increase the risk of silent lacunar infarct. Metabolic syndrome, homocysteinemia, renal failure and intima media thickness(IMT) are also other risk factors of the silent lacunar infarct. Cerebral microbleed, lacunar infarct and intracerebral hemorrhage(ICH) have similar pathology and pathogenesis. So, cerebral microbleed are coexisted with lacunar infarct, leukoaraiosis, hypertensive ICH and vascular dementia. Cerebral microbleed are associated with volume and recurrence of ICH. Also cerebral microbleed may reflect baseline status of blood brain barrior disruption. Silent lacunar infarct and cerebral microbleed are very important to clinical management, but in the aspect of insurance medicine and independent medical examiners, these lesions are not subject of evaluation for handicap.

• The Journal of Korean Medicine
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• v.29 no.1
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• pp.192-199
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• 2008

Objective : Silent infarct is more common in healthy elderly people and seems associated with risk of future stroke. However, the prevalence and risk factors of silent infarct are unclear. We investigated the prevalence and risk factors of silent infarct. Methods : 56 first-ever cerebral infarct patients were enrolled in this study. CT images were made of all 56 patients. We divided them into two groups according to the presence of silent infarcts and comparedage, sex, education period, WHR, hypertension, diabetes mellitus, hyperlipidemia, smoking, numbness and weakness of thumb and index finger, neck stiffness, facial spasm, and blepherospasm. Result : Silent infarcts were found in 24 patients(43%). Most infarcts(48%) were located in basal ganglia. Age, sex, education period, WHR, numbness and weakness of thumb and index finger, neck stiffness, facial spasm, and blepherospasm were similar between the two groups. Diabetes mellitus, hyperlipidemia, and smoking were higher in the silent infarct group. Hypertension was higher in the non-silent infarct group. Conclusion : The prevalence of silent infarct in first-ever cerebral infarction patients was 43% and diabetes mellitus, hyperlipidemia, and smoking were higher in silent infarct patients.

• Journal of Chest Surgery
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• v.47 no.6
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• pp.510-516
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• 2014

Background: Acute cerebral infarction is a major risk factor for postoperative neurologic complications in cardiac surgery. However, the outcomes associated with acute silent cerebral infarction (ASCI) have not been not well established. Few studies have reported the postoperative outcomes of these patients in light of preoperative Diffusion-weighted magnetic resonance imaging (DWI). We studied the postoperative neurologic outcomes of patients with preoperative ASCI detected by DWI. Methods: We retrospectively studied 32 patients with preoperative ASCI detected by DWI. None of the patients had preoperative neurologic symptoms. The mean age at operation was $68.8{\pm}9.5$ years. Five patients had previous histories of stroke. Four patients had been diagnosed with infective endocarditis. Single cerebral infarct lesions were detected in 16 patients, double lesions in 13, and multiple lesions (>5) in three. The median size of the infarct lesions was 4 mm (range, 2 to 25 mm). The operations of three of the 32 patients were delayed pending follow-up DWI studies. Results: There were two in-hospital mortalities. Neurologic complications also occurred in two patients. One patient developed extensive cerebral infarction unrelated to preoperative infarct lesions. One patient showed sustained delirium over one week but recovered completely without any neurologic deficits. In two patients, postoperative DWI confirmed that no significant changes had occurred in the lesions. Conclusion: Patients with preoperative ASCI showed excellent postoperative neurologic outcomes. Preoperative ASCI was not a risk factor for postoperative neurologic deterioration.