Ritter M A, Dittrich R, Ringelstein E B
Klinik und Poliklinik für Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Str. 33, 48129 Münster, Deutschland.
Nervenarzt. 2011 Aug;82(8):1043-52. doi: 10.1007/s00115-011-3312-9.
Silent brain infarctions are frequently found by modern cerebral imaging. Up to 30% of persons without a clinical history of stroke were found to have silent brain infarction in epidemiological studies. "Silent" refers to ischemic brain lesions for which no matching clinical syndrome can be found based on history or clinical investigation. Age, education, and ethnic background have a strong impact on noticing and reporting stroke symptoms. The current clinical definition of stroke is insensitive for cognitive deficits which can also be caused by brain infarctions. The majority of silent brain infarctions are localized in the subcortical white matter of the brain; however, about 10% of silent brain infarctions are cortical. Silent brain infarctions are strongly associated with stroke risk factors and comorbidities that are known to cause clinically overt stroke. Silent brain infarctions are 5 to 10 times more frequent than clinically overt strokes. Silent brain infarctions as defined by DWI lesions on MRI imaging are a frequent finding during operative or interventional procedures and their monitoring may help improve the respective techniques in order to decrease the risk of periprocedural stroke.
现代脑成像技术经常能发现无症状性脑梗死。在流行病学研究中，高达30%无中风临床病史的人被发现患有无症状性脑梗死。“无症状”是指基于病史或临床检查找不到与之匹配临床综合征的缺血性脑损伤。年龄、教育程度和种族背景对中风症状的察觉和报告有很大影响。目前中风的临床定义对认知缺陷不敏感，而认知缺陷也可能由脑梗死引起。大多数无症状性脑梗死位于大脑皮质下白质；然而，约10%的无症状性脑梗死位于皮质。无症状性脑梗死与已知会导致临床显性中风的中风危险因素和合并症密切相关。无症状性脑梗死的发生率比临床显性中风高5至10倍。MRI成像上由弥散加权成像（DWI）病变定义的无症状性脑梗死在手术或介入操作过程中经常被发现，对其进行监测可能有助于改进相应技术，以降低围手术期中风的风险。
