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Related Experiment Videos

The course of patients with lacunar infarcts and a parent arterial lesion: similarities to large artery vs small

Oh Young Bang1, Sung Yeol Joo, Phil Hyu Lee

  • 1Department of Neurology, School of Medicine, Ajou University, Suwon, South Korea. nmboy@unitel.co.kr

Archives of Neurology
|April 21, 2004
PubMed
Summary

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Patients with lacunar syndrome and small deep infarcts who have a parent arterial lesion face a higher stroke recurrence risk. This finding suggests these cases are a form of large artery disease, not benign lacunar stroke.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • The role of parent artery occlusive lesions in patients experiencing lacunar syndrome (LS) and small deep infarcts (SDIs) identified via diffusion-weighted imaging (DWI) is not well understood.
  • Current understanding often assumes a benign course for such presentations.

Purpose of the Study:

  • To investigate and compare the risk of recurrent stroke in patients with LS and SDIs based on the presence or absence of a parent arterial lesion.
  • To determine if parent arterial disease (PAD) in this context represents a distinct clinical entity compared to small artery disease (SAD) and large artery disease (LAD).

Main Methods:

  • A prospective acute stroke registry from a university hospital was analyzed.
  • 173 patients were categorized into three groups: parent arterial disease (PAD) occluding deep perforators (n=32), small artery disease (SAD) (n=70), and large artery disease (LAD) (n=71).

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  • Patients were classified using clinical syndrome, DWI, and vascular studies. Recurrent strokes and 1-year prognosis were monitored.

    • Main Results:

    • The study observed 18 recurrent strokes and 9 deaths (6 vascular) during the 1-year follow-up.
    • The PAD group exhibited a significantly higher stroke recurrence rate (16%) compared to the SAD group (1%) (P=.01), but a similar rate to the LAD group (17%) (P=.87).
    • The presence of a parent arterial lesion was identified as the sole independent predictor of stroke recurrence in patients with LS and SDIs (OR, 13.8; 95% CI, 1.5-123.9; P=.02).

    Conclusions:

    • Despite clinical indicators of lacunar stroke (LS, SDIs, stable course), the PAD group demonstrates characteristics of intracranial large artery disease.
    • These findings challenge the traditional view of lacunar stroke as uniformly benign when associated with parent arterial lesions.
    • Identifying parent arterial lesions is crucial for risk stratification and management in patients presenting with LS and SDIs.