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Neurologically asymptomatic patients with a single cerebral lacuna
1Department of Neurology and Psychiatry, Tulane Medical School, New Orleans, LA.
Southern Medical Journal
|August 1, 1989
Summary
Patients with asymptomatic cerebral lacunae often have underlying hypertension and cardiac issues. A significant portion developed clinical stroke or other cardiovascular events within three years, highlighting the need for proactive management.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Cerebral lacunae are small infarcts often associated with hypertension.
- Asymptomatic lacunae may indicate subclinical cerebrovascular disease.
- Hypertension is a major risk factor for both stroke and cardiovascular disease.
Purpose of the Study:
- To investigate the clinical significance of asymptomatic cerebral lacunae.
- To identify associated cardiovascular risk factors in patients with lacunae.
- To determine the long-term outcomes of patients with single, asymptomatic cerebral lacunae.
Main Methods:
- Retrospective analysis of 16 patients with CT-confirmed single cerebral lacunae and no initial stroke symptoms.
- Assessment of cardiovascular risk factors including systemic arterial hypertension, left ventricular hypertrophy, cardiomegaly, and hypertensive retinopathy.
- Three-year follow-up to monitor for clinical stroke syndromes and other adverse events.
Main Results:
- All patients had systemic arterial hypertension; many showed signs of cardiac involvement (left ventricular hypertrophy, cardiomegaly) and hypertensive retinopathy.
- Lacunae were predominantly located in the supratentorial region.
- During follow-up, 7 patients developed clinical lacunar stroke, 3 had cortical stroke, 2 experienced myocardial infarction, and 1 died suddenly.
Conclusions:
- Asymptomatic cerebral lacunae in hypertensive individuals are associated with significant cardiovascular and cerebrovascular risks.
- These findings underscore the importance of identifying and managing hypertension in patients with incidental lacunar findings.
- Proactive cardiovascular and neurological monitoring is warranted in this patient population.