Lacunar stroke and subcortical arteriosclerotic encephalopathy
Abstract Clinical and neurovisual features were compared in 2 groups of patients who have survived the first lacunar stroke (LS). Group 1 included 35 patients (mean age 59.6 +/- 7.1 years), in stable state for 5.7 +/- 2.5 years; group 2 consisted of 39 patients (mean age 58.1 +/- 8.1 years) with LS as a debut of subcortical arteriosclerotic encephalopathy (SAE), illness duration after LS development--3.9 +/- 2.9 years. Several parameters revealed statistically significant between-group differences: "classical" lacunar syndromes, most frequently motor hemiparesis, were detected in 94% of group 1 patients and in 42% of group 2 patients. Pareses of the extremities were marked or moderate in 57% and 3% of the patients, respectively. Foci characteristic of LS were determined by MRI/CT in all the patients of group 1 and in 69% of the patients of group 2. Foci mean size (MRI, regime T1) was larger in group 1 (0.24 +/- 0.18 cm3), comparing to group 2 (0.11 +/- 0.06 cm3); foci shape was round or oval in 77% of patients in group 1 and irregular--in 51% of patients in group 2. In group 1, concomitant asymptomatic leucoareosis and lacunes were detected in 37% and 20%; in group 2--in 77% and 62%, respectively. The differences revealed may be used in prognosis of LS further course. These differences may be underlied by the lesions of intracerebral arteries of different size and differend of change occurrence that, to a certain extent, relate to different hemodynamic variants of arterial hypertension.