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Related Experiment Video

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Perfusion Status in Lacunar Stroke: A Pathophysiological Issue.

Marialuisa Zedde1, Manuela Napoli2, Ilaria Grisendi1

  • 1Neurology Unit, Stroke Unit, AUSL-IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy.

Diagnostics (Basel, Switzerland)
|June 28, 2023
PubMed
Summary

Lacunar stroke pathophysiology is debated, but advanced neuroimaging reveals perfusion deficits in some cases. This challenges previous assumptions and opens new avenues for understanding and treating small vessel occlusion.

Keywords:
CT perfusionDSC-MRIMRISVDacute strokecorelacunar strokepenumbraperforating arteryperfusionsmall vessel disease

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Area of Science:

  • Neurology
  • Neuroimaging
  • Cerebrovascular Disease

Background:

  • Lacunar infarction pathophysiology remains debated, relying on traditional methods like histopathology and animal models.
  • Recent advancements in neuroimaging offer higher resolution, enabling direct assessment of small vessel occlusion dynamics and tissue damage mechanisms.

Purpose of the Study:

  • To review the pathophysiological aspects of lacunar stroke.
  • To explore the applicability of the core-penumbra hypothesis to lacunar stroke.

Main Methods:

  • Review of existing literature on lacunar infarction pathophysiology.
  • Analysis of neuroimaging techniques, particularly magnetic resonance imaging (MRI).
  • Discussion of the core-penumbra concept in the context of small vessel occlusions.

Main Results:

  • Historically, perfusion deficits were not associated with lacunar infarcts.
  • Recent MRI studies suggest a perfusion defect exists in a subgroup of lacunar infarct patients.
  • This finding necessitates re-evaluation of lacunar stroke pathophysiology and imaging strategies.

Conclusions:

  • The core-penumbra hypothesis may be applicable to lacunar stroke, challenging prior beliefs.
  • Advanced neuroimaging is crucial for identifying perfusion deficits in acute lacunar stroke.
  • Further research is needed to elucidate the mechanisms and optimal imaging of perfusion defects in lacunar infarction.