Lacunar strokes: a single institutional experience

Year 2013, Volume: 38 Issue: 4, 659 - 666, 01.12.2013

Osama Shukir Muhammed Amin

Abstract

Abstract: Objective: Lacunar ischemic strokes comprise approximately 25% of all ischemic strokes. We compared the risk factors and clinical pattern of this type of stroke between males and females. Methods: This observational study involved 50 consecutive patients with their first-ever lacunar stroke and was conducted at the department of neurology of Sulaimaniya general teaching hospital, Iraq from December 1, 2010 to March 1, 2013. Patients" risk factors, clinical presentation, and strokes" patterns were noted and a comparison was made between males and females. Results: Males (64%) outnumbered females (36%) with a male to female ration of 1.7. The mean age of males was 63 years while it was 61 years in females. Although hypertension was more common in females than in males, diabetes and smoking were more common in the latter group; however, there were no statistically significant differences between the 2 genders in terms of hypertension (P-value

Keywords

lacunar infarction; stroke; lipohyalinosis; hypertension

Laküner İnmeler: Bir Kurumun Deneyimleri

Abstract

Amaç: Laküner Iskemik inmeler tüm iskemik inmelerin yaklaşık % 25"ini oluşturmaktadır.Bu çalışmada bu inme türünün kadınlar ve erkeklerde risk faktörleri ve klinik paternleri açısından karşılaştırılması amaçlanmıştır. Materyal ve Metod: Bu gözlemsel çalışma, ilk kez Laküner inmesi olan 50 ardışık hastada 1 Aralık 2010-1 Mart 2013 tarihleri arasında Irak Süleymaniye Genel Eğitim Hastanesi Nöroloji Bölümünde yapılmıştır.Hastaların risk faktörleri, klinik sunumu, ve inme paternleri kaydedilerek erkekler ve kadınlar arasında bir karşılaştırma yapıldı. Bulgular: Erkek ve kadın oranı 1.7"dir, erkekler (% 64) kadınlardan (% 36) sayıca fazladır. Kadınlarda ortalama yaş 61 iken erkeklerin yaş ortalaması 63"tür.Hipertansiyon kadınlarda erkeklere göre daha sık olmasına rağmen, diyabet ve sigara kullanımı erkeklerde daha yaygındır; ancak, 2 cinsiyet arasında hipertansiyon ve diyabet açısından istatistiksel olarak anlamlı bir fark yokken sigara kullanan erkeklerde anlamlı farklılıklar mevcuttur. Saf motor hemiparezi, ataksik hemiparezi, saf duyusal inme ve dizartri-beceriksiz el sendromu erkeklerde daha yaygındır; sadece sensorimotor inme erkeklerde istatistiksel olarak anlamlıdır (P-değeri

Keywords

Laküner enfarktüs, inme, lipohiyalinosis, hipertansiyon

References

• Wardlaw JN. What causes lacunar stroke. J Neurol Neurosurg Psychiatry. 2005; 76:617-9.
• You R, McNeil JJ, O'Malley HM, Davis SM, Donnan GA. Risk factors for lacunar infarction syndromes. Neurology. 1995; 45(8):1483-7.
• Fisher CM. Lacunar strokes and infarcts: a review. Neurology. 1982; 32:871-6.
• Bejot Y, Catteau A, Caillier M, Rouaud O, Durier J, Marie C, et al. Trends in incidence, risk factors, and survival in symptomatic lacunar stroke in Dijon, France, from 1989 to 2006: a population-based study. Stroke. 2008;39:1945-51.
• Besson G, Hommel M, Perret J. Historical aspects of the lacunar concept. Cerebrovasc Dis 1991;1:306-10. Bamford JM, Warlow CP. Evolution and testing of the lacunar hypothesis. Stroke. 1988; 19:1074-82.
• Fisher CM, Curry HB. Pure motor hemiplegia of vascular origin. Arch Neurol. 1965; 13:30-44.
• Fisher CM. Lacunes: small, deep cerebral infarcts. Neurology. 1965; 15:774-84.
• Fisher CM. The arterial lesions underlying lacunes. Acta Neuropathol. 1965; 12:1-15.
• Fisher CM, Cole M. Homolateral ataxia and crural paresis; A vascular syndrome. J Neurol Neurosurg Psychiatry. 1965; 28:48-55.
• Fisher CM. Pure sensory stroke involving face, arm, and leg. Neurology. 1965; 15:76-80.
• Fisher CM. A lacunar stroke: The dysarthria-clumsy hand syndrome. Neurology. 1967; 17:614-7.
• Fisher CM. Thalamic pure sensory stroke: A pathologic study. Neurology. 1978; 28:1141-4.
• Giroud M, Gras P, Milan C, Arveux P, Beuriat P, Vion P, et al. [Natural history of lacunar syndromes. Contribution of the Dijon registry of cerebrovascular complications]. Rev Neurol (Paris). 1991; 147:566
• Sacco S, Marini C, Totaro R, Russo T, Cerone D, Carolei A. A population-based study of the incidence and prognosis of lacunar stroke. Neurology. 2006; 66:1335-8.
• Millikan C, Futrell N. The fallacy of the lacune hypothesis. Stroke. 1990; 21:1251-7.
• Jackson CA, Hutchison A, Dennis MS, et al. Differing risk factor profiles of ischemic stroke subtypes: evidence for a distinct lacunar arteriopathy? Stroke. 2010; 41:624-9.
• Jackson C, Sudlow C. Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and non-lacunar infarcts. Stroke. 2005; 36:891-901.
• Mead GE, Lewis SC, Wardlaw JM, et al. Severe ipsilateral carotid stenosis and middle cerebral artery disease in lacunar ischaemic stroke: innocent bystanders? J Neurol. 2002; 249:266-71.
• Baumgartner RW, Sidler C, Mosso M, et al. Ischemic lacunar stroke in patients with and without potential mechanism other than small-artery disease. Stroke. 2003; 34:653-9.
• Tejada J, Diez-Tejedor E, Hernandez-Echebarria L, et al. Does a relationship exist between carotid stenosis and lacunar infarction? Stroke. 2003; 34:1404-11.
• Chamorro A, Sacco RL, Mohr JP, et al. Clinicalcomputed tomographic correlations of lacunar infarction in the Stroke Data Bank. Stroke. 1991; 22:175-81.
• Schonewille WJ, Tuhrim S, Singer MB, Atlas SW. Diffusion-weighted MRI in acute lacunar syndromes. A clinical-radiological correlation study. Stroke. 1999; 30:2066-9.