Davidson K W
Department of Family and Community Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock 72205.
J Am Board Fam Pract. 1988 Jan-Mar;1(1):57-62.
Lacunar strokes result from occlusion of penetrating arteries in the deeper, subcortical parts of the cerebrum and brain stem. Approximately 19 percent of all strokes are of the lacunar variety with lacunar strokes representing the most common cerebrovascular complication of chronic hypertension. Four major clinical syndromes are pure motor hemiparesis, pure sensory stroke, ataxic hemiparesis, and the dysarthria-clumsy hand syndrome. The advent of computed tomography (CT) has allowed the antemortem study of lacunar disease and has shed new light on the pathogenesis and clinical course of lacunar strokes. Recently, it has been demonstrated that lacunar strokes may be embolic or hemorrhagic in causation, are not invariably associated with hypertension, and may be larger and associated with hypertension, and may be larger and associated with neurological manifestations that do not conform to the classic patterns. In most instances, however, recognition of the characteristic clinical presentation and confirmation of the diagnosis with noninvasive studies spare many patients unnecessary risks associated with anticoagulation, arteriography, or vascular surgery.
腔隙性卒中是由大脑深部及脑干皮质下穿通动脉闭塞所致。所有卒中中约19%为腔隙性卒中，腔隙性卒中是慢性高血压最常见的脑血管并发症。四种主要临床综合征为纯运动性偏瘫、纯感觉性卒中、共济失调性偏瘫和构音障碍-手笨拙综合征。计算机断层扫描（CT）的出现使得能够在生前对腔隙性疾病进行研究，并为腔隙性卒中的发病机制和临床过程提供了新的认识。最近有研究表明，腔隙性卒中在病因上可能是栓塞性或出血性的，并非总是与高血压相关，可能更大且伴有不符合经典模式的神经学表现。然而，在大多数情况下，识别特征性临床表现并通过无创检查确诊，可使许多患者避免抗凝、动脉造影或血管手术带来的不必要风险。
