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We describe an analysis of 227 patients with lacunar infarcts;177 were inpatients and the remaining 50 were outpatients.The group comprised 11%of all inpatients with cerebrovascular pathology and 16%of all consecutive inpatients with brain infarcts studied at the Department of Neurology of the Hospital de la Santa Creu i Sant Pau.The main risk factors identified in these patients were arterial hypertension in 164(72%),diabetes mellitus in 64(28%),and heart disease in 58(26%).The most common clinical syndromes were pure motor hemiparesis in 125(55%),pure hemisensory stroke in 42 (18%),the sensorimotor deficit syndrome in 34(15%),ataxic hemiparesis in seven(3%),and the dysarthria-clumsy hand syndrome in four(2%);atypical syndromes were observed in 15 patients(7%).Lacunes were demonstrated by computed tomography in which it was applied.Magnetic resonance imaging was significantly better(p<0.001)than computed tomography for imaging lacunes, especially those located in either the pons(p<0.005)or the internal capsule(p<0.001).After the acute phase,mild or no neurologic disability was detected in 178 patients(78.4%),moderate disability persisted in 48 patients(21.1%),and severe disability was recorded in one case(0.4%). Lacunar infarcts are a clearly defined entity with characteristic clinical features and an excellent short-term prognosis.Magnetic resonance imaging is the current method of choice for demonstrating these small brain lesions. |
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cardiovascular disease cerebrovascular disease,risk factors in disability,neurological hypertension lacunar infarction monoparesis MRI MRI,abnormal MRI,CAT scan compared to prognosis pure motor stroke review article risk factors
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