Very Small Cerebral Lesions May Increase Risk of Stroke

Cerebral lesions of 3 mm or smaller, detected by MRI, may increase risk of stroke and death.

Magnetic resonance imaging detects very small cerebrovascular lesions, which may be associated with increased risks for stroke and death, according to a study published in the Annals of Internal Medicine.

Researchers from Mississippi, Maryland, Washington, Minnesota, and North Carolina sought to determine stroke risks associated with brain lesions 3 mm or smaller, which are typically ignored by clinicians, and white matter hypersensitivities (WMHs).

A total of 1,884 subjects, aged 50 to 73, with no prior history of stroke, participated in the study. All underwent MRI of the brain. The researchers evaluated:

Lesion size

WMH score (scale of 0 to 9)

Incident stroke

All-cause mortality

Stroke-related mortality

Follow-up was an average of 14.5 years.

The results showed that the stroke risk was tripled among patients who had lesions that were 3 mm or smaller, compared with patients who had no lesions seen by MRI. There were:

157 clinical strokes (89% were ischemic strokes)

50 stroke-related deaths

576 all-cause deaths

The researchers concluded that these very small cerebrovascular lesions may be associated with an increased risk of stroke and death, but more study is needed.

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