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无症状脑梗塞(SBI)是指无卒中病史而由神经影像学或尸检发现的梗塞。其症状可能未被认识或被病人遗忘或只有短暂缺血症状。SBI很常见,在无症状颈动脉病变的病人中,约15％的病人CT发现有梗塞;短暂性单眼盲病人中约25％及短暂性半球卒中病人中的相当比率的病人在CT检查时发现有短暂体征性脑梗塞(CITS);约10％的症状性卒中患者CT发现还有与其无关的其它梗塞。MRI检测SBI较CT更具敏感性,3组TIA病人中,103例SI病人中75％是由MRI检出的,相比之下,由CT发现的仅27％。许多SI小而部位深,较大的SI更多见于右半球。在CITS病人中,当TIA发作超过1h且恢复缓慢者,梗塞较常见。在颈动脉闭塞的病人中SI与狭窄的严重程度相关,而在颈动脉溃疡性损伤的患者中SI可能更常见。栓塞(包括心原性和动脉原性)和腔隙梗塞也许是SI的两个最常见发病机制。SI病人在危险因素方面与TIA病人和症状性脑梗塞病人差不多。SBI和症状性脑梗塞的存在,给临床医师提供一些关于病人脑血管病的自然病史信息。脑血管疾病患者的特征取决于下列几点:(1)症状(无、短暂性视网膜性、半球性、偏盲性、脑干/小脑或卒中);(2)脑的状态(正常、功能异常、梗塞);及(3)引起或可能引起卒中的心血管-血液疾病的性质、部位和严重程度。
Asymptomatic cerebral infarction (SBI) refers to an infarct found by neuroimaging or autopsy without a history of stroke. Symptoms may not be known or forgotten by the patient or have only transient ischemic symptoms. SBI is common and about 15% of patients with asymptomatic carotid lesions have infarcts detected by CT; about 25% of transient unilateral-blind patients and a significant proportion of patients with transient hemispheric stroke are found on CT examination There are transient signs of cerebral infarction (CITS); about 10% of patients with symptomatic stroke CT found there are other infarcts unrelated. MRI was more sensitive for detecting SBI than for CT, and 75% of 103 SI patients in the three TIA groups were detected by MRI compared with only 27% by CT. Many SI small and deep parts, larger SI more common in the right hemisphere. In patients with CITS, infarctions are more common when TIA attacks occur more than 1 h and recover slowly. SI is associated with the severity of stenosis in patients with carotid artery occlusion, whereas SI may be more common in patients with carotid artery ulcerative lesions. Embolization (including cardiogenic and arteriogenic) and lacunar infarcts may be the two most common pathogenesis of SI. SI patients have similar risk factors to those with TIA and symptomatic cerebral infarction. The presence of SBI and symptomatic cerebral infarction provides clinicians with some natural history of patients with cerebrovascular disease. The characteristics of patients with cerebrovascular disease depend on the following: (1) Symptoms (no, transient retinal, hemispheric, hemianopia, brainstem / cerebellum or stroke); (2) state of the brain (normal, dysfunctional, Infarct); and (3) the nature, location and severity of cardiovascular-blood disorders that cause or may cause stroke.