Department of Neurology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, University Maastricht, The Netherlands.
Stroke. 2012 Aug;43(8):2245-7. doi: 10.1161/STROKEAHA.112.660076. Epub 2012 Jun 12.
Studies in patients with lacunar stroke often assess the number of lacunes. However, data on how many symptomatic lacunar infarcts cavitate into a lacune are limited. We assessed the evolution of symptomatic lacunar infarcts over 2-year follow-up.
In 82 patients with first-ever lacunar stroke with a lacunar infarct in the deep brain regions (excluding the centrum semiovale), we performed a brain MR at presentation and 2 years later. We classified cavitation of lacunar infarcts at baseline and on follow-up MR as absent, incomplete, or complete. We recorded time to imaging, infarct size, and vascular risk factors.
On baseline MR, 38 (46%) index infarcts showed complete or incomplete cavitation. Median time to imaging was 8 (0-73) days in noncavitated and 63 (1-184) days in cavitated lesions (P<0.05). On follow-up imaging, 94% of the lacunar infarcts were completely or incompletely cavitated, most had reduced in diameter, and 5 (6%) had disappeared. Vascular risk factors were not associated with cavitation.
Cavitation and lesion shrinkage were seen in almost all symptomatic lacunar infarcts in the deep brain regions over 2-year follow-up. Counting lacunes in these specific regions at a random moment might slightly, however not substantially, underestimate the burden of deep lacunar infarction.
腔隙性卒中患者的研究常评估腔隙的数量。然而，关于有症状的腔隙性梗死灶有多少会发生空洞化的数据有限。我们评估了有症状的腔隙性梗死灶在 2 年随访期间的演变。
在 82 例首次发生的深部脑区（不包括半卵圆中心）腔隙性卒中且存在腔隙性梗死灶的患者中，我们在发病时和 2 年后进行了脑部磁共振成像（MR）检查。我们将基线和随访 MR 上腔隙性梗死灶的空洞化分为无、不完全或完全。我们记录了影像学检查时间、梗死灶大小和血管危险因素。
基线 MR 上，38 个（46%）指数梗死灶显示完全或不完全空洞化。未空洞化病变的中位影像学检查时间为 8（0-73）天，空洞化病变为 63（1-184）天（P<0.05）。随访时，94%的腔隙性梗死灶完全或不完全空洞化，大多数梗死灶直径缩小，5 个（6%）消失。血管危险因素与空洞化无关。
在 2 年随访期间，深部脑区的几乎所有有症状的腔隙性梗死灶都出现了空洞化和病灶缩小。在这些特定区域随机时刻计数腔隙可能会略微但不会显著低估深部腔隙性梗死的负担。
