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From the Division of Cerebrovascular Diseases, Department of Neurology (Drs. Davis, Bendixen, and Adams), and the Division of Biostatistics, Department of Preventive Medicine and Environmental Health (Drs. Clarke and Woolson), University of Iowa, Iowa City, IA; and the Veterans Affairs Medical Center (Dr. Culebras), Syracuse, NY.
Supported by USPHS-NIH-R01-27863 and 27960. Additional financial support, including the providing of study drugs, given by Organon, Inc.
Received July 24, 1995. Accepted in final form August 15, 1995.
Address correspondence and reprint requests to Dr. Patricia H. Davis, Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242-1053.
To determine the frequency, location, size, and risk factors for silent cerebral infarctions (SCIs) on brain CT, we identified 629 patients without a history of previous stroke who were enrolled in a multicenter clinical trial of therapy for acute ischemic stroke.On the baseline CT, 143 patients (22.7%) had SCIs; 34.3% of the lesions were in the right hemisphere, 38.5% in the left hemisphere, and 27.3% were bilateral. The lesion size was less than 1 cm in 65.7%, and the most common site was the basal ganglia (48.3%). Patients with SCI were compared with controls without SCI to determine the odds ratios (ORs) for each risk factor. On univariate analysis, race (black versus white) had an OR of 1.80 (95% confidence interval [CI], 1.14 to 2.85), male sex an OR of 1.68 (95% CI, 1.12 to 2.51), and congestive heart failure an OR of 1.88 (95% CI, 1.07 to 3.31). Significant risk factors on multivariate analysis include age (OR 1.03 per year, p equals 0.0070), male sex (OR 1.78, p equals 0.0094), and race (OR 2.43, p equals 0.0004). After including interaction terms with age and hypertension and age, sex, and race, hypertension was also a significant risk factor.
NEUROLOGY 1996;46: 942-948
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