Incidence of silent lacunar lesion in normal adults and its relation to cerebral blood flow and risk factors.

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Abstract
There are few reports comparing incidence of silent lacunar lesions detected by magnetic resonance imaging and cerebral blood flow in neurologically normal adults. We studied the incidence of such lesions and its relation to cerebral blood flow and risk factors in 246 neurologically normal adults (145 men, mean age 62 years; 101 women, mean age 60 years) who received health screening examinations of the brain. Thirty-two subjects (13%) had possible silent lacunar lesions (66% of these were recognized by both T1- and T2-weighted image). The regional cerebral blood flow measured by the xenon-133 inhalation method was significantly lower in subjects with silent lacunes than in those without (p less than 0.02). Cerebral blood flow was mildly but significantly decreased in those with silent lacunes (p less than 0.05). Periventricular hyperintensity was closely related to silent lacune (p less than 0.01). However, there was no significant difference in cerebral blood flow between subjects with and without apparent periventricular hyperintensity. Silent lacunar lesion was closely related to decrease of cerebral circulation and may be an important risk factor for symptomatic cerebrovascular disease.