Fisher C M
Neurology. 1982 Aug;32(8):871-6. doi: 10.1212/wnl.32.8.871.
At least 20 different lacunar syndromes have been described and can be recognized by characteristic clinical features. Almost all occur in patients with hypertension. Small lacunes are usually due to lipohyalinosis, larger ones to atheromatous or embolic occlusion of a penetrating vessel. The concept of the "lacunar state" is examined in the light of recent knowledge with the conclusion that the clinical deficit is primarily related to unrecognized normal pressure hydrocephalus rather than to the presence of a few lacunes. The notion that lacunes occur haphazardly is criticized because the first or only lacune tends to be symptomatic. The incidence of cerebral lacunes has declined since the introduction of antihypertensive therapy, an indication that therapy is effective.
至少已描述了20种不同的腔隙综合征，可通过特征性临床特征识别。几乎所有病例都发生在高血压患者中。小腔隙通常是由于脂质透明变性，大腔隙则是由于穿通血管的动脉粥样硬化或栓塞性闭塞。根据最新知识对“腔隙状态”的概念进行了研究，得出的结论是，临床缺陷主要与未被认识的正常压力脑积水有关，而不是与少数腔隙的存在有关。有人批评腔隙随机发生的观点，因为首个或唯一的腔隙往往是有症状的。自引入抗高血压治疗以来，脑腔隙的发生率有所下降，这表明治疗是有效的。
