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Infraputaminal 'lacunes'. Clinical and pathological correlations

P M Pullicino1, L L Miller, A V Alexandrov

  • 1Department of Neurology, Buffalo General Hospital, State University of New York 14203, USA.

Stroke
|September 1, 1995
PubMed
Summary

Infraputaminal lacunes (IPLs) are enlarged perivascular spaces, not infarcts. These lesions can be distinguished from lacunar infarcts on specific MRI sequences, clarifying their pathology and clinical significance.

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Area of Science:

  • Neuroimaging
  • Neuropathology
  • Vascular Neurology

Background:

  • Infraputaminal lacunes (IPLs) are oval lesions inferior to the lateral putamen, often misidentified as lacunar infarcts on CT/MRI.
  • Understanding the clinical relevance and pathology of IPLs is crucial for accurate diagnosis.

Purpose of the Study:

  • To determine the clinical relevance and underlying pathology of infraputaminal lacunes (IPLs).
  • To differentiate IPLs from lacunar infarcts using imaging and histopathology.

Main Methods:

  • Reviewed MR scans for IPLs and analyzed clinical features and vascular risk factors.
  • Performed histological and microangiographic analysis on postmortem samples.
  • Conducted a MEDLINE search for similar imaging lesions.

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Main Results:

  • IPLs were found in 3% of MR scans and in nine additional patients.
  • No neurological symptoms were linked to IPLs, and they showed no difference in risk factors compared to controls.
  • Histopathology confirmed IPLs as enlarged perivascular spaces (EPVSs), distinct from infarcts, and identifiable on proton density MR sequences.

Conclusions:

  • Infraputaminal lacunes (IPLs) are a type of enlarged perivascular space (EPVS).
  • IPLs can be differentiated from lacunar infarcts using proton density MR imaging.