Single lacunar brain infarction with transient signs versus those with long-lasting signs

In order to find out the difference between single brain lacunar infarctions with transient signs and those with long-lasting signs, cerebral blood flow studies and blood tests were performed.

Ten cases of single lacunar infarction with transient signs and 10 of single lacunar infarction with long-lasting signs were studied. Subcortical cystic infarctions with a diameter of less than 1.5 cm were defined as lacunar infarction. Episodes lasting less than 24 hours were classified as transient signs and those lasting 24 hours or more as long-lasting signs.

cerebral blood flows were measured using the stable xenon computed tomography method. The regional cerebral blood flows were measured before and 20 minutes after the intravenous injection of 17 mg/kg acetazolamide. Plasma fibrinopeptide A, platelet factor 4 and beta-thromboglobulin concentrations were determined at the Special Reference Laboratories.

Blood flows in the cerebral cortex and cerebral white matter contralateral to the lacunar infarction were lower in the group with long-lasting signs than in that with transient signs. Cerebrovascular acetazolamide reactivity in the cerebral cortex and white matter contralateral to the lacunar infarction were lower in the group with long-lasting signs than in that with transient signs. Plasma fibrinopeptide A, platelet factor 4 and beta-thromboglobulin concentrations were higher in the long-lasting signs group than in that with transient signs.

There may be some differences in pathogenesis between single lacunar infarction with transient signs and those with long-lasting signs.