An anatomical assessment of brain infarcts : a MRI study

Abstract

An infarct is an area which has lost its blood supply due to obstruction, thrombosis or embolism. It is the third leading cause of death in the Western world, following non-cerebral cardiovascular disease and cancer. This research study focused on determining the infarct prevalence according to age, sex and brain areas most affected by infarcts. The prevalence of different infarct types was also determined. Brain MRI statistics were obtained from a Private Radiology practice in Pretoria for a 13-month period. A total of 1844 brain MRI examinations were evaluated, of which 299 patients presented with infarcts. Their age and sex were noted and their individual reports were obtained to record the anatomical structures and brain lobes that were infarcted. The infarct types were also noted. Diffusion-weighted images were used to measure new infarcts, while FLAIR images were used to measure old infarcts. Results showed an overall incidence of 16.10% and vascular structures accounted for 26.63% of these. Most infarcts were new (56.80%) and mainly affected patients aged 70–79 years (31.36%). Normal cerebral infarcts (72.49%) and embolic infarcts (14.50%) were the most common. The parietal lobe (34.91%) and right middle cerebral artery (11.54%) presented with the most infarcts. The right hemisphere (34.91%) presented with slight infarct predominance, but this was not significant when compared to the left (31.95%) hemisphere (Chi square p>0.05). No significant difference was found concerning the overall male to female ratio (Chi square p>0.05). Females aged 18–39 years of age presented with three times more infarcts than their male counterparts. This may possibly be due to their use of oral contraceptives and pregnancy, which increases the risk of thrombosis and embolism. Females over 80 years also presented with higher infarct prevalence, which is expected, since men die at earlier ages due to other co-morbidities such as cancer.