Study for the prevention of ischemic stroke in patients with asymptomatic cerebrovascular disease

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The aim of this study is to observe the chronological changes of asymptomatic cerebral lesions on MRI, including perivascular spaces, Asymptomatic Cerebral Infarction (ACI), Periventricular Hyperintensity (PVH), and Deep and Subcortical White Matter Hyperintensity (DSWMH) for 5 years, to evaluate the relation between asymptomatic cerebral lesions and the risk factors, and to clarify the effects of medical treatments on asymptomatic cerebral lesions. One hundred seventeen patients with asymptomatic cerebrovascular disease (mean age, 67±11 years) were recruited. The score of PVH+DSWMH significantly became worse compared with on registration, although there was no significant change when it was examined independently. The number of infarct under 3 - 5 mm, 5 - 10 mm, and the whole size of the infarct for 5 years were significantly increased compared with on registration. The number of infarct at 3- and 4- year period in the group over 65 years old was significantly increased compared with … More that in the group under 65 years old. Hypertensive group showed a significant exacerbation in the score of DSWMH and PVH+DSWMH, compared to non-hypertensive group. There was no effect of total cholesterol level on asymptomatic cerebral lesions, but the group with low HDL cholesterol level showed a significant increase in the number of infarct at 1- and 5- year period, compared to the group with normal or high HDL cholesterol level. The group with abnormal triglyceride level also showed a significant exacerbation in the score of PVH and PVH+DSWMH at 3-year period compared to the group with normal triglyceride level. The group with abnormal blood glucose level showed a significant exacerbation in the score of PVH at 1-year period compared to the group with normal blood glucose level. Finally, the group treated with anti-platelet agents demonstrated a significant reduction in the number of infarct at 3 to 5- year period compared to the group treated without anti-platelet agents. These results may lead to the preventive strategy against symptomatic infarct in patients with ACI. Less