SILENT INFARCTION ON A 2ND CT SCAN IN 91 PATIENTS WITHOUT MANIFEST STROKE IN THE DUTCH TIA TRIAL

The frequency of silent infarction is an important issue because it is a marker of vascular disease. We studied the occurrence of silent inf arction in a sample of patients from the Dutch TIA trial, in which pat ients were randomized between 30 and 283 mg of aspirin. A total of 91 patients with TIA or non-disabling ischemic stroke and who did not suf fer a stroke during a period of one to four years (mean 32 months) und erwent CT scanning both on entry and at the end of the study. A cardia c source of embolism was an exclusion criterion for the trial. We foun d only one patient with a possibly silent infarction, in four patients a previously detected symptomatic infarct on CT was no longer visible . The rarity of silent infarction in this study may have several expla nations: (1) the relatively short period of follow-up. (2) the selecti on of patients (no cardiac source of embolism). (3) the clinical monit oring at four monthly intervals aimed at detection of focal ischemia, (4) the use of aspirin. Given these circumstances, silent infarction i s an infrequent problem.