| 1. |
- Lindgren, Arne, et al.
(author)
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Cerebral lesions on magnetic resonance imaging, heart disease, and vascular risk factors in subjects without stroke. A population-based study
- 1994
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In: Stroke: a journal of cerebral circulation. - 1524-4628. ; 25:5, s. 929-934
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Journal article (peer-reviewed)abstract
- BACKGROUND AND PURPOSE: To assess the prevalence of asymptomatic abnormalities on magnetic resonance imaging of the brain and their possible relation to hypertension, heart disease, and carotid artery disease, we studied 77 randomly selected subjects (mean age, 65.1 years; range, 36 to 95 years) with no history of focal brain lesions. METHODS: The study protocol included magnetic resonance imaging of the brain, transthoracic and transesophageal echocardiography, ultrasonography of the carotid arteries, and electrocardiographic recording. Deep and periventricular white matter hyperintensities on magnetic resonance imaging were assessed both separately and together. RESULTS: On magnetic resonance imaging of the brain 62.3% (95% confidence interval [CI], 51.5% to 73.2%) of the subjects had white matter hyperintensities. These abnormalities increased significantly with age (chi 2 test; P = .0001), from 13.6% (95% CI, 0% to 28.0%) of subjects aged younger than 55 years to 85.2% (95% CI, 71.8% to 98.6%) of subjects aged 75 years or older. Six subjects had deep gray matter hyperintensities localized in the basal ganglia, and one had a cerebellar infarction. Stepwise logistic regression analysis identified age and a history of heart disease (but not echocardiographic findings) to be independently associated with deep and periventricular white matter hyperintensities. Hypertension was only independently associated with periventricular white matter hyperintensities. Of the 68 subjects examined with both transthoracic and transesophageal echocardiography, potential cardioembolic sources were detected in 38.2% (95% CI, 26.7% to 49.8%) of the subjects with transthoracic echocardiography and in 47.1% (95% CI, 35.2% to 58.9%) of those with transthoracic and transesophageal echocardiography combined. In subjects aged 75 years or older, a possible cardiac embolic source was detected in 64.0% on transthoracic echocardiography and in 72.0% on transthoracic and transesophageal echocardiography combined, compared with 5.3% and 15.8%, respectively, in subjects aged younger than 55 years. CONCLUSIONS: White matter hyperintensities and potential cardioembolic sources are frequently present in asymptomatic individuals, stressing the need for age-matched control subjects in studies of patients with stroke or dementia.
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| 2. |
- Magnusson, M, et al.
(author)
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Cerebellar infarctions and 'vestibular neuritis'
- 1993
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In: Acta Oto-Laryngologica, Supplement. - 0365-5237. ; 503, s. 6-64
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Journal article (peer-reviewed)abstract
- Consecutive subjects 50 to 75 years of age with sudden onset of vertigo but without cochlear or neurological symptoms were investigated with neuro-imaging techniques. Doppler sonography of the vertebral and carotid arteries and recording of voluntary saccades and pursuit eye movements, caloric, spontaneous, gaze and optokinetic nystagmus. Among those studied, 6 out of 24 subjects could be demonstrated to have cerebellar infarctions, another 2 subjects had occlusion of one vertebral artery. Caloric tests could not identify subjects with a cerebellar infarction whereas prominently reduced pursuit eye movements could. Subjects with cerebellar infarction either had a vertebral artery occlusion or prominent cardio-embolic risk factors. It is suggested that subjects with symptoms as vestibular neuritis should be investigated with pursuit eye movements and with at least standard ECG recordings.
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