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Computed tomographic changes in lacunar syndromes.

Jacques De Reuck1, Dimitri Hemelsoet, Lotte Nieuwenhuis

  • 1Department of Neurology, University Hospital, Ghent, Belgium. jacques.dereuck@yucom.be

Clinical Neurology and Neurosurgery
|November 29, 2005
PubMed
Summary
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Repeated CT scans help predict lacunar syndrome outcomes. Smaller lacunes that shrink over time indicate better recovery, while larger, unchanged lacunes suggest disability.

Area of Science:

  • Neurology
  • Radiology
  • Stroke Medicine

Background:

  • Lacunar syndromes (LACS) result from small deep infarcts with variable clinical presentations and outcomes.
  • Prognostic indicators for LACS are crucial for patient management and treatment strategies.

Purpose of the Study:

  • To investigate the prognostic value of serial computed tomographic (CT) scans in patients diagnosed with lacunar syndrome (LACS).
  • To compare changes in lacune size and characteristics on CT scans between patients with different functional outcomes at 3 months.

Main Methods:

  • 32 patients with first-ever stroke diagnosed as LACS underwent non-contrast CT scans on day 3 and day 10 post-symptom onset.
  • Lacunes were identified, and their size and X-ray attenuation were assessed for changes between scans.

Related Experiment Videos

  • Patients were categorized into independent (modified Rankin scale 0-2) and handicapped (modified Rankin scale 3-5) groups at 3 months.

    • Main Results:

    • Patients with poorer outcomes were older, more impaired on admission, and had more cardiac issues and cognitive decline.
    • Leukoaraiosis was more prevalent in the handicapped group.
    • While average lacune size on day 3 and 10 was not significantly different between groups overall, smaller lacunes that decreased in size from day 3 to 10 were associated with independence.

    Conclusions:

    • Patient age, cognitive and cardiac status, and leukoaraiosis presence are factors influencing LACS outcome.
    • The size and changes in size of the symptomatic lacune on serial CT scans are significant prognostic indicators for lacunar syndrome recovery.