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[Lacunar infarct and deep cerebral hemorrhage: a comparison of the risk factors]
Insights
Different vascular risk factors distinguish lacunar infarcts (LIc) from deep cerebral hemorrhages (DCH). Arterial hypertension is more prevalent in DCH patients, suggesting distinct underlying mechanisms for these stroke types.
Area of Science:
- Neurology
- Vascular Medicine
- Stroke Research
Background:
- Lacunar infarcts (LI) and deep cerebral hemorrhages (DCH) share similar small perforating artery vasculopathy, often linked to arterial hypertension (AHT).
- Understanding the distinct vascular risk factors is crucial for differentiating these stroke types.
Purpose of the Study:
- To compare vascular risk factors in patients with lacunar infarcts (LIc) versus deep cerebral hemorrhages (DCH).
- To investigate how differing risk factors influence the development of LIc or DCH.
Main Methods:
- Prospective analysis of 1,540 patients with cerebral vascular accidents (CVA).
- Data collection included demographics and risk factors: transient ischemic accident (TIA), AHT, diabetes mellitus (DM), hypercholesterolemia, ischemic cardiopathy, atrial fibrillation, and silent infarcts on CT.
Main Results:
- Significant differences observed between LIc and DCH regarding TIA history, DM, hypercholesterolemia, and silent infarcts.
- DM was not an independent variable in multivariant analysis.
- Higher arterial blood pressure was noted in the DCH group.
Conclusions:
- Distinct risk factor profiles for LIc and DCH suggest different etiological mechanisms.
- Identifying these differing risk factors is key to understanding the pathogenesis of each stroke type.
Introduction:
Lacunar infarcts (LI) and deep cerebral hemorrhages (DCH) have the same localization and a vasculopathy which appears to be similar, at the level of the small perforating arteries, classically attributed to arterial hypertension (AHT).
Objectives:
To compare the vascular risk factors of patients with lacunar ictus (LIc) and those with DCH, to try to determine how these may affect the appearance of one type of stroke or another.
Patients And Methods:
We analyzed a prospective consecutive series of patients with cerebral vascular accidents (CVA), selecting 1,540 patients in the first 1,155 with a first CVA. We recorded demographic data and the following risk factors: previous transient ischemic accident (TIA), AHT, diabetes mellitus (DM), hypercholesterolemia, ischemic cardiopathy, atrial fibrillation and the presence of silent infarcts on CT.
Results:
Two hundred and four patients had LIc and 163 had DCH. There was a significant dissociation between LIc and a history of TIA, DM, hypercholesterolemia and the presence of silent lacunar-type infarcts on CT. However, after multivariant analysis, DM did not continue to be an independent variable. Arterial blood pressure was found to be greater in the DCH group.
Conclusions:
The presence of different risk factors for LIc and DCH may be the key to understanding the mechanism which leads to one type or other of CVA.