Acute Simultaneous Multiple Lacunar Infarcts: A Severe Disease Entity in Small Artery Disease
European Neurology, 05/10/2012
Lee JH et al. – The main pathophysiology of simultaneous multiple lacunar infarcts (sMLI) may be small artery disease. However, clinico–radiological characteristics suggest that sMLI may be a more severe entity of small artery disease compared to SLI.Methods
- The authors retrospectively reviewed stroke patients with sMLI or SLI in a consecutively collected stroke registry with a predefined long-term clinical follow-up.
- Clinical characteristics, including vascular risk factors, rheological profiles, premorbid functional status, and clinical outcome were evaluated.
- In addition, radiological characteristics, including white matter ischemic changes, previous lacunes, microbleeds, and concomitant intra- or extracranial arterial stenosis were evaluated.
- Of the 548 acute ischemic stroke patients, sMLI was found in 23 (13.5%) and SLI in 148 (86.5%).
- There was no difference in vascular risk factors and rheological profiles between the two groups, except for advanced age and more frequent previous history of stroke in the sMLI group.
- The sMLI group also showed more previous lacunes (p < 0.001) and microbleeds (p < 0.001).
- A cardioembolic or atherothrombotic stroke mechanism was rare in both groups.
- Recurrent strokes were more frequent in the sMLI group.