Arboix A, Martí-Vilalta J L
Unitat de Patologia Vascular Cerebral del Servei de Neurologia, L'Aliança-Hospital de Barcelona.
Rev Clin Esp. 1997 Nov;197(11):757-9.
There is scarce knowledge on the mode of onset of disease related to circadian rhythm in lacunar syndromes.
A prospective clinical analysis was conducted in 181 patients with lacunar infarcts (LI) and 47 patients with lacunar syndromes not due to lacunar infarcts. In every patient the onset of the disease was recorded for each of the four 6-hour equal periods of the day. The injure volume of the LI was measured by means of a computer and image analyzer. A descriptive analysis of the hour of onset of the disease and a comparative analysis of clinical differences and injure size for each day period, relating to circadian rhythm were made.
For LI, the onset occurred during nocturnal sleep in 32.5% and during wakening hours in 67.5%. The morning onset of the disease was significantly more frequent in lacunar syndromes by cerebral hemorrhage (55.5%) than in LI (24.5%) (p < 0.001). For LI, the mean injure volume was significantly larger when associated with a morning onset (2,574 mm3), during the afternoon (1,678 mm3) or during the night (1,328 mm3) (p < 0.04). At discharge, no significant differences were documented between hospital stay length and also between functional disability, when compared with disease onset and circadian rhythm.
A third of patients with LI had their onset of symptoms during nocturnal sleep. The morning onset of the disease regarding circadian rhythm in LI is associated with a larger injure volume.
