Abstract
Stroke following endovascular intervention can be both clinically apparent and “silent”, detected incidentally on imaging. Silent brain infarcts (SBI) can be detected in up to 67%–80% patients undergoing thoracic aortic interventions.1,2 Why so many SBI do not lead to more apparent neurological deficits is a kind of miracle, as their distribution in the cerebral vascular bed is random. Their long term implications for cognitive decline are concerning but poorly defined, largely due to a lack of controlled studies with pre- and post-operative diffusion weighted MRI (DW-MRI), and medium to long term cognitive assessments.
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