Covert brain infarctions: an illustrative teaching series

The lifetime risk of stroke for adults of 25 years of age or older is approximately 25%, while stroke constitutes the second most common cause of mortality and the second most common cause of disability worldwide. In addition to the clinically manifest acute ischaemic stroke, the presence of cerebral infarction in patients without apparent clinical symptoms and signs attributed to ischaemic stroke or transient ischaemic attack was first described by Fisher in a series of autopsies. Over the years, the term 'silent brain infarction' has been replaced by the term 'covert cerebrovascular disease' (CCD).Despite the well-established evidence surrounding the associated sequelae of CCD, the current diagnostic and therapeutic algorithms in this particular group of patients are not well defined. With this case series, we showcase potential aetiologies and the value of individualised work-up and treatment strategies.