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Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I. Correlation with age and cerebrovascular risk factors
Awad IA, Spetzler RF, Hodak JA, Awad CA, Carey R.. Stroke, 1986-11-01
Topic: Risk, prevention and care in population studies
Patchy subcortical foci of increased signal intensity are frequently identified on magnetic resonance imaging (MRI) in the elderly. The incidence and clinical correlates of these lesions remain unknown. In this report, 240 consecutive MRI scans performed over a 6-month period were reviewed (excluding patients with recent brain trauma or known demyelinating disease). Subcortical incidental lesions (ILs) were identified, which could not be accounted for by the patient's current clinical diagnosis, neurological status, or CT scan. The ILs were graded according to size, multiplicity, and location. The incidence and severity of ILs increased with advancing age (p less than 0.0005). Among patients over 50 years of age, the incidence and severity of ILs were correlated with a previous history of history of ischemic cerebrovascular disease (p less than 0.05) and with hypertension (p less than 0.05). Multivariable regression analysis identified age, prior brain ischemia, and hypertension as the major predictors of ILs in the elderly. Diabetes, coronary artery diseases, and sex did not play a significant role. With the exception of cerebrovascular disease, there was no association between ILs and any particular clinical entity, including dementia. It is concluded that subcortical parenchymal lesions are frequent incidental findings on MRI in the elderly, and may represent an index of chronic cerebrovascular diseases in such patients.
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APA 7th
Awad, I. A., Spetzler, R. F., Hodak, J. A., Awad, C. A., & Carey, R. (1986). Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I. Correlation with age and cerebrovascular risk factors. Stroke. https://doi.org/10.1161/01.str.17.6.1084
Vancouver
Awad IA, Spetzler RF, Hodak JA, Awad CA, Carey R. Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I. Correlation with age and cerebrovascular risk factors. Stroke. 1986. doi:10.1161/01.str.17.6.1084. PMID: 3810705.
BibTeX
@article{awad1986-3810705,
author = {Awad, I. A. and Spetzler, R. F. and Hodak, J. A. and Awad, C. A. and Carey, R.},
title = {{Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I. Correlation with age and cerebrovascular risk factors}},
journal = {Stroke},
year = {1986},
doi = {10.1161/01.str.17.6.1084},
pmid = {3810705},
url = {https://doi.org/10.1161/01.str.17.6.1084}
}
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Key findings
- Diabetes, coronary artery diseases, and sex did not play a significant role.
- It is concluded that subcortical parenchymal lesions are frequent incidental findings on MRI in the elderly, and may represent an index of chronic cerebrovascular diseases in such patients.
Why it matters
Small areas of changed signal on MRI in the elderly became more common and more severe with age and were linked to prior cerebrovascular disease and hypertension. Apart from cerebrovascular disease, these incidental lesions were not associated with any particular clinical condition, including dementia.
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Study details
- Evidence strengthLow
How this study scored 45/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 44 of the 97 points we could judge it on, which is 45 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | 3 / 4 | Stroke: journal h-index 455 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1986 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 589 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 14.0 citations a year over 42 year(s) since 1986 |
| Impact for its field and year | 4 / 6 | Cited 11.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Robert M. Carey: h-index 105 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 3810705) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 44 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 44 of the 97 points we could judge it on is 45 out of 100. |
| Total | 45 / 100 | — |
What each of these 20 components measures, and what this score is not →
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