Anzalone N, Landi G
Neurological Clinic, Ospedale Policlinico, Milano, Italy.
J Neurol Neurosurg Psychiatry. 1989 Oct;52(10):1188-90. doi: 10.1136/jnnp.52.10.1188.
To evaluate the prevalence of lacunar syndromes due to non ischaemic causes 97 consecutive patients with recent (less than 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.
为评估非缺血性病因所致腔隙综合征的患病率，我们对97例近期（少于72小时）出现公认腔隙综合征的连续患者进行了研究。调查显示，9例由非缺血性病变引起（4例原发性脑出血、1例霉菌性动脉瘤破裂、1例脑脓肿、1例硬膜下血肿、1例胶质母细胞瘤、1例多发性硬化症）。临床特征无法区分非缺血性患者和缺血性患者；然而，高血压在后一组中明显更常见，其在识别缺血性患者中的阳性预测值为96.6%。非缺血性病因所致腔隙综合征并不罕见；由于CT扫描使2例患者得到了恰当治疗，并在另外5例患者中显示了抗血栓治疗的禁忌证，因此对于急性腔隙综合征患者，尤其是血压正常者，早期使用CT扫描似乎是必要的。
