Silent cerebrovascular disease : a risk factor for future ischemic stroke?

Takeaway

  • Silent cerebrovascular disease (SCD) discovered incidentally via routine neuroimaging was associated with significantly increased risk of future ischemic stroke and could be an avenue for primary stroke prevention.

Why this matters ?

  • Evidence of SCD, including silent brain infarction (SBI) and white matter disease (WMD), is a common incidental finding in routine clinical care. The American Heart Association/American Stroke Association has earmarked SBI as a critical priority for new studies on stroke prevention.

  • However, the logistics of investigating SBI in clinical studies are complex: SCD screening programs are not established, patients may not be informed of an SBI finding, no ICD-9 codes exist for SBI or WMD, and SCD is not usually reported in structured fields of electronic health records.

  • To address these challenges, the investigators have developed a natural language processing (NLP) algorithm to identify patients with SCD per automated review of neuroradiology reports. Using this technique, an investigation of SCD and ischemic stroke risk was feasible.