Relationship between silent brain infarction and rheumatic diseases

Abstract

Aim Silent brain infarction (SBI) is a vascular disease without any clinical symptoms that is detected in brain imaging. The diagnosis of SBI vary according to the SBI identification and imaging method used. Inflammatory diseases and treatments may cause SBI at an early age because of the increased risk of thrombosis. We aimed to determine the relationship between cranial lesions and rheumatologic disease. Methods Data were obtained from the clinical files of 4560 patients who were between 20 and 60 years of age, applied to the neurology out-patient clinic between January 2013 and December 2015 and had cranial magnetic resonance imaging (MRI). The Fazekas scale was used to define the load and location of the lesions. Patients over 60 years of age, younger than 20 years, with hypertension, diabetes mellitus, hyperlipidemia, previous cerebrovascular disease, white matter lesion consistent with demyelinating disease, or large vessel occlusion were excluded.Results SBI was detected in 254 (5.5%) patients. Connective tissue disease in 13 patients, rheumatoid arthritis in 9 patients, Behçet’s disease in 6 patients, anti-phospholipid syndrome in 2 patients and other rheumatic diseases in 3 patients were detected. There was no statistically significant difference between the groups with and without rheumatologic disease in terms of lesion load and localization.
There was a positive correlation between age and lesion load.Conclusion Brain MRI findings alone are inadequate in diagnosing SBI without clinical findings and specific laboratory indicators for the patients.

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