Computed tomography in patients presenting with lacunar syndromes

Area of Science:

• Neurology
• Radiology
• Vascular Medicine

Background:

• Lacunar syndrome is a clinical presentation of stroke.
• CT scans are commonly used to diagnose stroke.
• Identifying the cause of stroke is crucial for treatment.

Purpose of the Study:

• To investigate the relationship between clinical lacunar syndrome and CT findings.
• To determine the necessity of angiography in patients with lacunar syndrome.

Main Methods:

• Retrospective analysis of 312 stroke patients.
• Review of CT scans for infarcts.
• Correlation of clinical presentation with imaging findings.
• Performance of angiography in select cases.

Main Results:

• 37 patients presented with lacunar syndrome.
• 18 showed lacunar infarcts on CT, 13 had normal scans, and 6 had large infarcts.
• Large infarcts included pure motor hemiplegia and pure sensory stroke.
• Angiography revealed treatable embolic sources in both lacunar and large infarcts.

Conclusions:

• Clinical lacunar syndrome can be associated with large cerebral infarcts.
• CT scan demonstration of lacunar infarcts does not preclude the need for angiography.
• Angiography is essential in appropriate cases to identify treatable embolic sources.