EAN 2021 | Association of chronic covert brain infarction with etiology of first-ever acute ischemic stroke

Covert brain infarctions are post-ischemic lesions in patients without a history of stroke. Thomas Meinel, MD, Bern University Hospital, and University of Bern, Bern, Switzerland, discusses a study looking at the association of chronic covert brain infarction with the etiology of first-ever acute ischemic stroke. The study was initiated after one patient presented with severe stroke, no prior stroke symptoms but three additional chronic post-ischemic lesions. Dr Meinel questioned if those patients with chronic lesions but no prior stroke symptoms have a different etiology compared to patients with M1-occlusion but without post-ischemic additional lesions. Patients encompassed in the imaging database with first-ever stroke and MRI on admission were included in the study. Results show a plausible pathophysiological association between additional cortical lesions and cardioembolism and large-artery stenosis. The etiology of the acute ischemic stroke differs according to the presence, number, and imaging phenotype of additional chronic lesions. Therefore, those additional chronic lesions could be used to develop individualized diagnostic work-up for patients with first-ever ischemic stroke. This interview took place during the European Academy of Neurology 2021 congress.