Horowitz D R, Tuhrim S, Weinberger J M, Rudolph S H
Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029.
Stroke. 1992 Mar;23(3):325-7. doi: 10.1161/01.str.23.3.325.
Lacunes are thought to occur in patients with hypertension or diabetes mellitus as a result of small-vessel disease. This study evaluated the importance of other stroke mechanisms in a population of patients with lacunar infarction.
We evaluated 108 consecutive patients with a lacune in the lenticulostriate distribution for other stroke risk factors such as carotid and cardiac disease.
Hypertension was present in 68% of the patients and diabetes mellitus in 37%; both occurred in 28% and neither occurred in 23%. Noninvasive carotid studies identified atherosclerotic plaque as a possible embolic source in 23%. By previously established criteria, 18% were at high risk for cardioembolism. Of those with hypertension or diabetes mellitus, 36% were at risk for a carotid or cardiac embolus. Of those without hypertension or diabetes mellitus, 32% had a possible carotid or cardiac etiology.
The high incidence of carotid and cardiac disease in those with and without hypertension or diabetes mellitus suggests the importance of other stroke mechanisms in this population. Patients with lacunar infarction should therefore be evaluated for other causes of stroke that may be treatable.
腔隙性脑梗死被认为是高血压或糖尿病患者因小血管病变所致。本研究评估了其他卒中机制在腔隙性脑梗死患者群体中的重要性。
我们连续评估了108例豆纹动脉分布区有腔隙性梗死的患者，以寻找其他卒中危险因素，如颈动脉和心脏疾病。
68%的患者有高血压，37%有糖尿病；二者皆有的占28%，二者皆无的占23%。无创颈动脉检查发现23%的患者有动脉粥样硬化斑块，可能为栓子来源。根据先前制定的标准，18%的患者有高心源性栓塞风险。在有高血压或糖尿病的患者中，36%有颈动脉或心脏栓子风险。在无高血压或糖尿病的患者中，32%有颈动脉或心脏病因的可能。
无论有无高血压或糖尿病，颈动脉和心脏疾病的高发病率表明其他卒中机制在该群体中的重要性。因此，对腔隙性脑梗死患者应评估其他可能可治疗的卒中病因。
