Silent Cerebral Infarctions in Type II Diabetes Mellitus Patients; Could Brain MRI Be a Routine Investigation?
Author(s)
Mohamed Hamdy Ibrahim,
Taha Kamel Alloush,
Marwa Adel Shaaban,
Mohammed Khalid Abdul Rahim,
Mohammad Ahmad M. Saad
Affiliation(s)
Neurology Department, Faculty of medicine, Ain shams University, Cairo, Egypt. Radiology Department, Misr University for Science and Technology, Cairo, Egypt. Internal Medicine Department, Gulf Medical University, Ajman, UAE. Radiology Department, Fayoom University, Fayoom, Egypt.
Neurology Department, Faculty of medicine, Ain shams University, Cairo, Egypt. Radiology Department, Misr University for Science and Technology, Cairo, Egypt. Internal Medicine Department, Gulf Medical University, Ajman, UAE. Radiology Department, Fayoom University, Fayoom, Egypt.
ABSTRACT
Objective: To study the prevalence of silent cerebral infarction in Type II diabetes mellitus. Patients and Methods: The study was a prospective on 80 patients recruited from neurology, endocrine outpatient clinics. Patients were type II diabetics as described by the American Diabetes Association, 2011 criteria. All patients underwent full metabolic profiles to diagnose diabetes mellitus and MRI brain scans to detect cerebral infarction. Results: Silent cerebral infarctions were detected in 60% of patients (48/80 patients) predominately along periventricular white matter area and subcortical areas (Basal ganglia, Thalamus). Conclusion: Asymptomatic Type II diabetes mellitus patients could have vascular cerebral changes without neurological symptoms. MRI brain scans could be recommended as routine diagnosis (if possible) for early cerebral infarct detection in type II diabetic patients.
Cite this paper
Ibrahim, M. , Alloush, T. , Shaaban, M. , Rahim, M. and Saad, M. (2014) Silent Cerebral Infarctions in Type II Diabetes Mellitus Patients; Could Brain MRI Be a Routine Investigation?. Open Journal of Medical Imaging, 4, 112-116. doi: 10.4236/ojmi.2014.43016.
Ibrahim, M. , Alloush, T. , Shaaban, M. , Rahim, M. and Saad, M. (2014) Silent Cerebral Infarctions in Type II Diabetes Mellitus Patients; Could Brain MRI Be a Routine Investigation?. Open Journal of Medical Imaging, 4, 112-116. doi: 10.4236/ojmi.2014.43016.
References
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http://dx.doi.org/10.1161/01.STR.28.6.1158 [2] Fisher, C.M. (1965) Lacunes: Small, Deep Cerebral Infarcts. Neurology, 15, 774-784.
http://dx.doi.org/10.1212/WNL.15.8.774 [3] American Diabetes Association (2010) Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 33, S62-S69.
http://dx.doi.org/10.2337/dc10-S062 [4] Brant-Zawadzki, M., Fein, G., Van Dyke, C., Keirman, R., Davenport, L. and De Groot, J. (1985) MR Imaging of the Aging Brain. American Journal of Neuroradiology, 6, 675-682. [5] Price, T.R., Manolio, T.A., Kronmal, R.A., Kittner, S.J., Yue, N.C., Robbins, J., Anton-Culver, H. and O’Leary, D.H. (1997) Silent Brain Infarction on Magnetic Resonance Imaging and Neurological Abnormalities in Community-Dwelling Older Adults. Stroke, 28, 1158-1164.
http://dx.doi.org/10.1161/01.STR.28.6.1158 [6] Ezekowitz, M.D., James, K.E., Nazarian, S.M., Davenport, J., Broderick, J.P., Gupta, S.R., Thadani, V., Meyer, M.L. and Bridgers, S.L. (1995) Silent Cerebral Infarction in Patients with Nonrheumatic Atrial Fibrillation. The Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation Investigators. Circulation, 92, 2178-2182.
http://dx.doi.org/10.1161/01.CIR.92.8.2178 [7] Xavier, A.R., Qureshi, A.I., Kirmani, J.F., Yahia, A.M. and Bakshi, R. (2003) Neuroimaging of Stroke: A Review. Southern Medical Journal, 96, 367-379. [8] Kase, C.S., Wolf, P.A., Chodosh, E.H., Zacher, H.B., Kelly-Hayes, M., Kannel, W.B., D’Agostino, R.B. and Scampini, L. (1989) Prevalence of Silent Stroke in Patients Presenting with Initial Stroke: The Framingham Study. Stroke, 20, 850-852.
http://dx.doi.org/10.1161/01.STR.20.7.850 [9] Davis, P.H., Clarke, W.F., Bendixen, B.H., Culebras, A., Adams, H.P. and Woolson, R.F. (1994) Silent Stroke in Patients Enrolled in the TOAST Study. Neurology, 44, A225. [10] Chodosh, E.H., Foulkes, M.A., Kase, C.S., Wolf, P.A., Mohr, J.P., Hier, D.B., Price, T.R. and Furtado, J.G. (1988) Silent Stroke in the NINCDS Stroke Data Bank. Neurology, 38, 1674-1679.
http://dx.doi.org/10.1212/WNL.38.11.1674 [11] Jorgensen, H.S., Nakayama, H., Raaschou, H.O., Gam, J. and Olsen, T.S. (1994) Silent Infarction in Acute Stroke Patients: Prevalence, Localization, Risk Factors and Clinical Significance: The Copenhagen Stroke Study. Stroke, 25, 97-104.
http://dx.doi.org/10.1161/01.STR.25.1.97 [12] Herderschee, D., Hidra, A., Algna, A., Koudstaal, P.J., Kappelle, L.J. and Van Gijn, J. (1992) Silent Stroke in Patients with Transient ischemic Attack or Minor Ischemic Stroke. Stroke, 23, 1220-1226.
http://dx.doi.org/10.1161/01.STR.23.9.1220 [13] Bryan, R.N., Wells, S.W., Miller, T.J., Elster, A., Jungreis, C., Poirier, V., Lind, B. and Manolio, T.A. (1997) Prevalence and Anatomic Characteristics of Infarct-Like Lesions on MRI in the Elderly: Data from the Cardiovascular Health Study (CHS). Radiology, 202, 47-54.
http://dx.doi.org/10.1148/radiology.202.1.8988191 [14] Kumar, V., Fausto, N., Abbas, A.K., Cotran, R.S. and Robbins, S.L. (2005) Robbins and Cotran Pathologic Basis of Disease. 7th Edition, Saunders, Philadelphia, 1194-1195. [15] Gardner, D. and Shoback, D. (2011) Greenspan’s Basic & Clinical Endocrinology. 7th Edition, McGraw-Hill Medical, New York, Chapter 17. [16] Nakamura, T., Kawagoe, Y., Matsuda, T., Ueda, Y., Ebihara, I. and Koide, H. (2005) Silent Cerebral Infarction in Patients with Type 2 Diabetic Nephropathy. Effects of Antiplatelet Drug Dilazepdihydrochloride. Diabetes/Metabolism Research and Reviews, 21, 39-43.
http://dx.doi.org/10.1002/dmrr.473
[1] Price, T.R., Manolio, T.A., Kronmal, R.A., Kittner, S.J., Yue, N.C., Robbins, J., Anton-Culver, H. and O’Leary, D.H. (1997) Silent Brain Infarction on Magnetic Resonance Imaging and Neurological Abnormalities in Community-Dwelling Older Adults. The Cardiovascular Health Study. Stroke, 28, 1158-1164.
http://dx.doi.org/10.1161/01.STR.28.6.1158 [2] Fisher, C.M. (1965) Lacunes: Small, Deep Cerebral Infarcts. Neurology, 15, 774-784.
http://dx.doi.org/10.1212/WNL.15.8.774 [3] American Diabetes Association (2010) Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 33, S62-S69.
http://dx.doi.org/10.2337/dc10-S062 [4] Brant-Zawadzki, M., Fein, G., Van Dyke, C., Keirman, R., Davenport, L. and De Groot, J. (1985) MR Imaging of the Aging Brain. American Journal of Neuroradiology, 6, 675-682. [5] Price, T.R., Manolio, T.A., Kronmal, R.A., Kittner, S.J., Yue, N.C., Robbins, J., Anton-Culver, H. and O’Leary, D.H. (1997) Silent Brain Infarction on Magnetic Resonance Imaging and Neurological Abnormalities in Community-Dwelling Older Adults. Stroke, 28, 1158-1164.
http://dx.doi.org/10.1161/01.STR.28.6.1158 [6] Ezekowitz, M.D., James, K.E., Nazarian, S.M., Davenport, J., Broderick, J.P., Gupta, S.R., Thadani, V., Meyer, M.L. and Bridgers, S.L. (1995) Silent Cerebral Infarction in Patients with Nonrheumatic Atrial Fibrillation. The Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation Investigators. Circulation, 92, 2178-2182.
http://dx.doi.org/10.1161/01.CIR.92.8.2178 [7] Xavier, A.R., Qureshi, A.I., Kirmani, J.F., Yahia, A.M. and Bakshi, R. (2003) Neuroimaging of Stroke: A Review. Southern Medical Journal, 96, 367-379. [8] Kase, C.S., Wolf, P.A., Chodosh, E.H., Zacher, H.B., Kelly-Hayes, M., Kannel, W.B., D’Agostino, R.B. and Scampini, L. (1989) Prevalence of Silent Stroke in Patients Presenting with Initial Stroke: The Framingham Study. Stroke, 20, 850-852.
http://dx.doi.org/10.1161/01.STR.20.7.850 [9] Davis, P.H., Clarke, W.F., Bendixen, B.H., Culebras, A., Adams, H.P. and Woolson, R.F. (1994) Silent Stroke in Patients Enrolled in the TOAST Study. Neurology, 44, A225. [10] Chodosh, E.H., Foulkes, M.A., Kase, C.S., Wolf, P.A., Mohr, J.P., Hier, D.B., Price, T.R. and Furtado, J.G. (1988) Silent Stroke in the NINCDS Stroke Data Bank. Neurology, 38, 1674-1679.
http://dx.doi.org/10.1212/WNL.38.11.1674 [11] Jorgensen, H.S., Nakayama, H., Raaschou, H.O., Gam, J. and Olsen, T.S. (1994) Silent Infarction in Acute Stroke Patients: Prevalence, Localization, Risk Factors and Clinical Significance: The Copenhagen Stroke Study. Stroke, 25, 97-104.
http://dx.doi.org/10.1161/01.STR.25.1.97 [12] Herderschee, D., Hidra, A., Algna, A., Koudstaal, P.J., Kappelle, L.J. and Van Gijn, J. (1992) Silent Stroke in Patients with Transient ischemic Attack or Minor Ischemic Stroke. Stroke, 23, 1220-1226.
http://dx.doi.org/10.1161/01.STR.23.9.1220 [13] Bryan, R.N., Wells, S.W., Miller, T.J., Elster, A., Jungreis, C., Poirier, V., Lind, B. and Manolio, T.A. (1997) Prevalence and Anatomic Characteristics of Infarct-Like Lesions on MRI in the Elderly: Data from the Cardiovascular Health Study (CHS). Radiology, 202, 47-54.
http://dx.doi.org/10.1148/radiology.202.1.8988191 [14] Kumar, V., Fausto, N., Abbas, A.K., Cotran, R.S. and Robbins, S.L. (2005) Robbins and Cotran Pathologic Basis of Disease. 7th Edition, Saunders, Philadelphia, 1194-1195. [15] Gardner, D. and Shoback, D. (2011) Greenspan’s Basic & Clinical Endocrinology. 7th Edition, McGraw-Hill Medical, New York, Chapter 17. [16] Nakamura, T., Kawagoe, Y., Matsuda, T., Ueda, Y., Ebihara, I. and Koide, H. (2005) Silent Cerebral Infarction in Patients with Type 2 Diabetic Nephropathy. Effects of Antiplatelet Drug Dilazepdihydrochloride. Diabetes/Metabolism Research and Reviews, 21, 39-43.
http://dx.doi.org/10.1002/dmrr.473