Frequency of Silent Lacunar Cerebral Infarction in Patients with Type 2 Diabetes Mellitus

Abstract Background Diabetes mellitus type II causes different stroke subtypes, particularly lacunar stroke. Most cerebral lacunar infarctions do not cause a neurological deficit. So, they are called “clinically silent”. Objectives We aimed to study the frequency of silent lacunar cerebral infarctions in patients with Type II diabetes mellitus and to identify patients’ demographic, laboratory, and imaging characteristics. Patients and Methods This Cross-sectional study was conducted at the Internal Medicine Department of Ain Shams University Hospital, and included 92 patients diagnosed with type II diabetes mellitus according to the American diabetes association’s 2021 criteria. Participants underwent comprehensive physical and neurological examinations to detect the presence of any subtle neurological signs, as well as HbA1c and lipid profiles. Brain imaging, with the Philips Achieva 3 Tesla MRI scanner, was utilized to detect silent cerebral lacunar infarctions. Results Silent cerebral lacunar infarctions were detected in 92.4 % of patients (85/92 patients) predominately in the Corona radiata, Centrum semi-oval, and subcortical areas including the Basal ganglia, Pons, and Thalamus. Conclusion Asymptomatic patients with Type II diabetes mellitus could have vascular cerebral changes without neurological symptoms. Brain MRI scanning can be recommended as a routine investigation in neurologically asymptomatic type 2 diabetic patients who have a mean age of 56.8± 7.86 years old, and duration of illness above 10 years, especially males, regardless of HbA1c and lipid profile levels, to detect early vascular ischemic changes.