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To evaluate the prevalence of lacunar syndromes due to non ischaemic causes 97 consecutive patients with recent(<72 hours)onset of a recognised lacunar syndrome were studied.Investigations showed that nine cases were due to non ischaemic pathologies(four primary intracerebral haemorrhages, one rupture of a mycotic aneurysm,one cerebral abscess,one subdural haematoma,one glioblastoma,one multiple sclerosis).Clinical features did not allow a separation of non ischaemic from ischaemic patients;however, hypertension was significantly more frequent in the latter group,and its positive predictive value in identifying ischaemic patients was 96.6%. Lacunar syndromes due to non ischaemic causes are not rare;since CT scan allowed appropriate treatment in two patients and demonstrated contraindications to antithrombotic therapy in five others,its early use appears warranted in patients with acute lacunar syndromes,particularly if normotensive. |
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abscess,intracerebral
aneurysm
glioma
intracerebral hemorrhage
lacunar infarction
lacunar infarction,differential diagnosis of
multiple sclerosis
multiple sclerosis,differential diagnosis of
multiple sclerosis,misdiagnosis
mycotic aneurysm
neoplasm,primary of CNS
subdural hematoma
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