Silent brain infarcts in chronic kidney disease patients with nonspecific neurological symptoms

  • P Sasanka Assistant Professor, Department of Nephrology, GSL Medical College, Rajahmundry, Andhra Pradesh, India
  • Dr. T. Jaya Chandra Professor, Department of Microbiology, GSL Medical College, Rajahmundry, Andhra Pradesh, India
Keywords: Study, Participant, Levels

Abstract

Introduction: Silent brain infarcts (SBI) are parenchymal lesions of previous infarcts, classified as type III cerebrovascular disorder. A study was undertaken to find the relation between SBIs and nonspecific neurological complaints, an association of high sensitivity C-reactive protein (hsCRP) with silent brain infarcts.

Methodology: It was a cross-sectional study conducted in the department of Nephrology, GSL Medical College, from January to December 2020. Individuals aged > 18 years with nonspecific neurological complaints were included. MRI brain, hsCRP and electrocardiogram were also carried as per the standard protocol. Fischer exact test was used to find the statistical significance; P < 0.05 was considered statistically significant.

Results: A total of 51 members have included the male-female ratio was 1.04. SBI was presented in 27.4% (14). Age-wise, among the cortical SBI patients, maximum (75%) were in the> 61 years group. High density lipoprotein levels were > 40 mg/dL in 39.2%, normal triglycerides (TGL) were observed in 71% and raised hsCRP in 62.7% (32). Statistically, there was no significant difference in TGL levels. hsCRP levels were raised in 3 (75%) members with cortical SBI; statistically, there was no significant difference.

Conclusion: The traditional risk factors associated with stroke were present in the patients with SBI. hsCRP was raised in chronic kidney disease patients having NSCL and having SBI.

Downloads

Download data is not yet available.

References

Das RR, Seshadri S, Beiser AS, Kelly-Hayes M, Au R, Himali JJ, Kase CS, et al. prevalence and correlates of silent cerebral infarcts in the Framingham offspring study. Stroke. 2008 Nov;39(11):2929-35. doi: 10.1161/STROKEAHA.108.516575.

Eguchi K, Kario K, Shimada K. Greater impact of coexistence of hypertension and diabetes on silent cerebral infarcts. Stroke. 2003 Oct;34(10):2471-4. doi: 10.1161/01.STR.0000089684.41902.CD.

Hougaku H, Matsumoto M, Kitagawa K, Harada K, Oku N, Itoh T, et al. Silent cerebral infarction as a form of hypertensive target organ damage in the brain. Hypertension. 1992 Dec;20(6):816-20. doi: 10.1161/01.hyp.20.6.816.

Putaala J, Kurkinen M, Tarvos V, Salonen O, Kaste M, Tatlisumak T. Silent brain infarcts and leukoaraiosis in young adults with first-ever ischemic stroke. Neurology. 2009 May 26;72(21):1823-9. doi: 10.1212/WNL.0b013e3181a711df.

Vermeer SE, Longstreth WT Jr, Koudstaal PJ. Silent brain infarcts: a systematic review. Lancet Neurol. 2007 Jul;6(7):611-9. doi: 10.1016/S1474-4422(07)70170-9.

Wersching H, Duning T, Lohmann H, Mohammadi S, Stehling C, Fobker M, et al. Serum C-reactive protein is linked to cerebral microstructural integrity and cognitive function. Neurology. 2010 Mar 30;74(13):1022-9. doi: 10.1212/WNL.0b013e3181d7b45b.

Hoshi T, Kitagawa K, Yamagami H, Furukado S, Hougaku H, Hori M. Relations of serum high-sensitivity C-reactive protein and interleukin-6 levels with silent brain infarction. Stroke. 2005 Apr;36(4):768-72. doi: 10.1161/01.STR.0000158915.28329.51.

Fornage M, Chiang YA, O'Meara ES, Psaty BM, Reiner AP, Siscovick DS, et al. Biomarkers of Inflammation and MRI-Defined Small Vessel Disease of the Brain: The Cardiovascular Health Study. Stroke. 2008 Jul;39(7):1952-9. doi: 10.1161/STROKEAHA.107.508135.

Nakane H, Ibayashi S, Fujii K, Sadoshima S, Irie K, Kitazono T, Fujishima M. Cerebral blood flow and metabolism in patients with silent brain infarction: occult misery perfusion in the cerebral cortex. J Neurol Neurosurg Psychiatry. 1998 Sep;65(3):317-21. doi: 10.1136/jnnp.65.3.317.

Prabhakaran S, Wright CB, Yoshita M, Delapaz R, Brown T, DeCarli C, Sacco RL. Prevalence and determinants of subclinical brain infarction: the Northern Manhattan Study. Neurology. 2008 Feb 5;70(6):425-30. doi: 10.1212/01.wnl.0000277521.66947.e5.

Park K, Yasuda N, Toyonaga S, Tsubosaki E, Nakabayashi H, Shimizu K. Significant associations of metabolic syndrome and its components with silent lacunar infarction in middle aged subjects. J Neurol Neurosurg Psychiatry. 2008 Jun;79(6):719-21. doi: 10.1136/jnnp.2007.134809.

Chiu YH, Wu SC, Tseng CD, Yen MF, Chen TH. Progression of pre-hypertension, stage 1 and 2 hypertension (JNC 7): a population-based study in Keelung, Taiwan (Keelung Community-based Integrated Screening No. 9). J Hypertens. 2006 May;24(5):821-8. doi: 10.1097/01.hjh.0000222750.82820.19.

Fisher Cm. Lacunes: Small, deep cerebral Infarcts. Neurology. 1965 Aug;15:774-84. doi: 10.1212/wnl.15.8.774.

Masuda J, Nabika T, Notsu Y. Silent stroke: pathogenesis, genetic factors and clinical implications as a risk factor. Curr Opin Neurol. 2001 Feb;14(1):77-82. doi: 10.1097/00019052-200102000-00012.

Sacco, Ralph L., et al. "Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline." Stroke 37.2 (2006): 577-617.

Van Dijk EJ, Prins ND, Vermeer SE, Vrooman HA, Hofman A, Koudstaal PJ, Breteler MM. C-reactive protein and cerebral small-vessel disease: the Rotterdam Scan Study. Circulation. 2005 Aug 9;112(6):900-5. doi: 10.1161/CIRCULATIONAHA.104.506337.

Willey JZ, Moon YP, Paik MC, Yoshita M, Decarli C, Sacco RL, Elkind MS, Wright CB. Lower prevalence of silent brain infarcts in the physically active: the Northern Manhattan Study. Neurology. 2011 Jun 14;76(24):2112-8. doi: 10.1212/WNL.0b013e31821f4472.

Putaala J, Metso AJ, Metso TM, Konkola N, Kraemer Y, Haapaniemi E, et al. analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry. Stroke. 2009 Apr;40(4):1195-203. doi: 10.1161/STROKEAHA.108.529883.

Kato T, Inoue T, Yamagishi S, Morooka T, Okimoto T, Node K. Low-density lipoprotein subfractions and the prevalence of silent lacunar infarction in subjects with essential hypertension. Hypertens Res. 2006 May;29(5):303-7. doi: 10.1291/hypres.29.303.

Uehara T, Tabuchi M, Mori E. Risk factors for silent cerebral infarcts in subcortical white matter and basal ganglia. Stroke. 1999 Feb;30(2):378-82. doi: 10.1161/01.str.30.2.378.

Norrving B. Lacunar infarcts: no black holes in the brain are benign. Pract Neurol. 2008 Aug;8(4):222-8. doi: 10.1136/jnnp.2008.153601.

Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998 Jul;15(7):539-53. doi: 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S.

CITATION
DOI: 10.17511/ijmrr.2021.i04.11
Published: 2021-10-04
How to Cite
1.
P Sasanka, Dr. T. Jaya Chandra. Silent brain infarcts in chronic kidney disease patients with nonspecific neurological symptoms. Int J Med Res Rev [Internet]. 2021Oct.4 [cited 2024Apr.24];9(4):274-9. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1320
Section
Original Article