Large vessel atherosclerotic infarction and lacunar lesions

Lacunar infarcts are small deep infarcts resulting from an occlusion of a perforating artery, and account for about a quarter of all ischemic strokes. Some new investigations indicate that subcortical lacunar lesions may have a greater chance of causing a progressive cerebral stroke than deep lacunar lesions in future. The goal of this study was to determine the frequency of subcortical and deep lacunar lesions and its association with large vessel atherosclerotic infarction at the Ali-Ibne-Abi Taleb Hospital, Rafsanjan.

In a cross-sectional study with consecutive sampling of patients with clinical suspicion of cerebral strokes that were assessed with magnetic resonance imaging (MRI), patients with ischemic strokes were selected. Diagnosis of large vessel atherosclerotic infarction was confirmed with carotid Duplex/Trancranial Doppler sonography. Then patients with lacunar lesions on MRI were assessed about their locations. One hundred and eighty patients were studied. The data were analyzed by SPSS software.

57.8% of patients were women and 42.2% were men. 58.6% of patients were older than 60 years. 67.8% of patients had deep lacunar lesions, 28.3% had subcortical lacunar lesions, and 3.9% had both. 56.11% had a history of hypertension. In patients with a history of hyperlipidemia, 80.1% had deep lacunar lesions. Frequencies of hypertension and hyperlipidemia were significantly higher among the patients with deep lacunar lesion (p < 0.01).

There is no association between large vessel atherosclerotic infarction and the site of lacunar lesions. Both hyperlipidemia and hypertension are risk factors for deep lacunar lesions.