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Clinical lacunar syndromes as predictors of lacunar infarcts. A comparison of acute clinical lacunar syndromes and findings on diffusion-weighted MRI

Author:
  • Arne Lindgren
  • Gert Staaf
  • Bo Geijer
  • Sara Brockstedt
  • Freddy Ståhlberg
  • Stig Holtås
  • Bo Norrving
Publishing year: 2000
Language: English
Pages: 128-134
Publication/Series: Acta Neurologica Scandinavica
Volume: 101
Issue: 2
Document type: Journal article
Publisher: Wiley-Blackwell

Abstract english

OBJECTIVES: To evaluate if patients with acute lacunar syndromes have acute lacunar infarcts or other types of cerebral lesions on diffusion-weighted MRI. METHODS: Patients with acute lacunar syndromes underwent echo-planar diffusion MRI of the brain within 3 days after stroke onset. Localization and size of lesions with hyperintense signal were determined, compared with clinical characteristics and with findings on follow-up T2-weighted MRI. RESULTS: Twenty-three patients participated in the study. Thirteen patients had pure motor stroke, 1 pure sensory stroke, 8 sensorimotor stroke, and 1 ataxic hemiparesis. Twenty-two patients had at least one lesion with increased signal on diffusion-weighted MR images. These acute lesions were in the internal capsule/ basal ganglia/thalamus in 13 patients, subcortical white matter in 5 patients, brainstem in 2 patients, cortex (multiple small lesions) in 1 patient, and cortex + basal ganglia in 1 patient. The median volume of the lesions was 0.6 ml on the initial examination and on follow-up, of 17 patients after 1 to 5 months, 0.5 ml. CONCLUSIONS: Almost all patients with acute ischemic lacunar syndromes have acute lesions on echo-planar diffusion-weighted MRI within 3 days after stroke onset. These lesions are mostly small and subcortical, compatible with lacunar infarcts caused by single penetrating artery occlusion, but in a minor proportion of patients (2 of 23 in our study) a cortical involvement is found.

Keywords

  • Neurology
  • diffusion MRI
  • cerebral infarction
  • stroke
  • acute
  • lacunar syndrome
  • lacunar infarct

Other

Published
  • ISSN: 1600-0404
Freddy Ståhlberg
E-mail: freddy.stahlberg [at] med.lu.se

Professor

Medical Radiation Physics, Lund

+46 46 17 31 19

+46 70 688 31 19

32

Professor

Diagnostic Radiology, (Lund)

+46 46 17 70 30

32