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Does a relationship exist between carotid stenosis and lacunar infarction?
J Tejada1, E Díez-Tejedor, L Hernández-Echebarría
1Division of Neurology, Hospital de León, 24008 León, Spain. jtejada@hleo.insalud.es
Stroke
|May 10, 2003
Summary
Carotid stenosis (CS) plays a significant role in the development of lacunar infarction (LI), particularly when it affects the ipsilateral side. This finding challenges the traditional view of CS in lacunar stroke patients.
Area of Science:
- Neurology
- Vascular Neurology
- Cerebrovascular Disease
Background:
- Carotid stenosis (CS) is often considered unrelated to lacunar infarction (LI).
- This study investigates the association between CS and LI, differentiating between single and multiple lacunar events.
Purpose of the Study:
- To determine the relationship between carotid stenosis and lacunar infarction.
- To assess differences between single and multiple lacunar infarctions in relation to CS.
Main Methods:
- Classified 330 patients with first-ever cerebral infarction into LI and non-LI groups.
- Identified single and multiple LIs, with further classification of multiple LIs by hemispheric distribution.
Main Results:
- Isolated ipsilateral CS was significantly more frequent in the LI group (OR, 5.5).
- A significant relationship was found between unilateral multiple LIs and homolateral CS >70% (OR, 4.4).
- Multivariate analysis identified left ventricular hypertrophy and homolateral CS >75% as predictors of unilateral multiple LI.
Conclusions:
- The high incidence of ipsilateral CS in patients with LI suggests a crucial role for CS in LI development.
- CS is an important factor in the pathogenesis of lacunar infarction, especially in cases with multiple lesions.