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Neuroradiology

, Volume 31, Issue 4, pp 316–319 | Cite as

The role of computed tomography in patients with lacunar stroke in the carotid territory

  • L. J. Kappelle
  • L. M. P. Ramos
  • J. van Gijn
Originals

Summary

In a prospective study of 78 patients presenting with recent clinical features of a supratentorially located lacunar infarct (LI), serial CT-scanning with contiguous 6, 5 or 3 mm slices was carried out. LI was found in 59 patients (76%; 95% confidence limits 65–85%). Lesions other than lacunar infarcts were found in 5 patients (6%; 95% confidence limits 2–14%); in only 14 patients could no abnormalities be detected (18%; 95% confidence limits 10–28%). There was no relationship between the detection rate on CT on the one hand and the type of lacunar syndrome, the number of previous TIA's, and the duration or severity of the neurological deficit on the other. A new protocol of CT-scanning for screening LI is advocated for situations where no MRI facilities are available or no patients cooperation can be obtained.

Key words

Lacunar infarction Computerized tomographic study Cerebrovascular disorders 

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References

  1. 1.
    Fisher CM (1982) Lacunar strokes and infarcts: a review. Neurology 32: 871–876Google Scholar
  2. 2.
    Brown JJ, Hesseling JR, Rothrock JF (1988) MR and CT of lacunar infarcts. AJNR 9: 477–482Google Scholar
  3. 3.
    Miyashita K, Naritomi H, Sawada T, Nakamura M, Kuriyama Y, Ogawa M, Imakita S (1988) Identification of recent lesions in cases of multiple small infarctions by magnetic resonance imaging. Stroke 19: 834–839Google Scholar
  4. 4.
    Awad I, Modic M, Little JR, Furlan AJ, Weinstein M (1986) Focal parenchymal lesions in transient ischemic attacks: correlation of computed tomography and magnetic imaging. Stroke 17: 399–403Google Scholar
  5. 5.
    Rothrock JF, Lyden PD, Hesselink JR, Brown JJ, Healy ME (1987) Brain magnetic resonance imaging in the evaluation of lacunar stroke. Stroke 18: 781–786Google Scholar
  6. 6.
    Pykett IL, Buonanno FS, Brady TJ, Kistler JP (1983) True Three-dimensional nuclear magnetic resonance neuro-imaging in ischemic stroke: correlation of NMR, X-ray CT and pathology. Stroke 14: 173–177Google Scholar
  7. 7.
    Bogousslavsky J, Fox AJ, Barnett HJM, Hachinsky V, Venitsky S, Carey LS (1986) Clinico-topographic correlation of small vertebrobasilar infarct using magnetic resonance imaging. Sroke 17: 929–938Google Scholar
  8. 8.
    Sipponen JT (1984) Visualization of brain infarction with nuclear magnetic resonance imaging. Neuroradiology 26: 387–391Google Scholar
  9. 9.
    Han JS, Bonstelle ChT, Kaufman B, Benson JE, Alfidi RJ, Clampitt RT, Van Dijke C, Huss RG (1984) Magnetic resonance imaging in the evaluation of the brainstem. Radiology 150: 705–712Google Scholar
  10. 10.
    Kistler JP, Buonanno FS, DeWitt LD, Davis KR, Brady TJ, Fisher CM (1984) Vertebral-basilar posterior ceeebral territory stroke-Delineation by proton nuclear magnetic resonance imaging. Stroke 15: 417–426Google Scholar
  11. 11.
    Weisberg LA (1979) Computed tomography and pure motor hemiparesis. Neurology 29: 490–495Google Scholar
  12. 12.
    Weisberg LA (1982) Lacunar infarcts. Clinical and computed tomography correlations. Arch Neurol 39: 37–40Google Scholar
  13. 13.
    Kappelle LJ, Van Gijn J (1986) Lacunar infarcts. Clin Neurol Neurosurg 88: 3–17Google Scholar
  14. 14.
    Calandre L, Gomara S, Bermejo F, Millan JM, Del Pozo G (1984) Clinical-CT correlations in TIA, RIND, and strokes with minimum residuum. Stroke 15: 663–665Google Scholar
  15. 15.
    Wall SD, Brant-Zawadzki M, Jeffrey RB, Barnes B (1982) High frequency CT findings within 24 hours affter cerebral infarction. AJR 138: 307–311Google Scholar
  16. 16.
    Bamford J, Sandercock P, Jones L, Warlow C (1987) The natural history of lacunar infarction: the Oxfordshire community stroke project. Stroke 18: 545–551Google Scholar
  17. 17.
    Nelson RF, Pullicino P, Kendall BE, Marshall J (1980) Computed tomography in patients presenting with lacunar syndromes. Stroke 11: 256–261Google Scholar
  18. 18.
    Donnan GA, Tress BM, Bladin PF (1982) A prospective study of lacunar infarction using computerized tomography. Neurology 32: 49–56Google Scholar
  19. 19.
    Loeb C, Gandolfo C, Mancardi GL, Primavera A, Tassinari T (1986) The lacunar syndromes: a review with personal contribution. In: Lechner H, Meyer JS, Ott E (eds). Cerebrovascular disease: Research and clinical management, vol 1. Elsevier, Amsterdam New York Oxford, pp 107–156Google Scholar
  20. 20.
    Rascol A, Clanet M, Manelfe C, Guiraud B, Bonafé A (1982) Pure motor hemiplegia: CT study of 30 cases. Stroke 13: 11–17Google Scholar
  21. 21.
    Soison T, Cabanis EA, Iba-Zizen MT, Bousser MG, Laplane D, Castaigne P (1982) Hémiplégie motrice pure et tomodensitométrie. J Neuroradiol 9: 304–322Google Scholar
  22. 22.
    Fischer CM (1982) Pure sensory stroke and allied conditions. Stroke 13: 434–447Google Scholar
  23. 23.
    Bladin PF, Berkovic SF (1984) Striatocapsular infarction: large infarcts in the lenticulostriate arterial territory. Neurology 34: 1423–1430Google Scholar
  24. 24.
    Pullicino P, Nelson RF, Kendall BE, Marshall J (1980) Small deep infarcts diagnosed on computed tomography. Neurology 30: 1090–1096Google Scholar
  25. 25.
    Mori E, Tabuchi M, Yamadori A (1985) Lacunar syndrome due to intracerebral hemorrhage. Stroke 15: 454–459Google Scholar
  26. 26.
    Weisberg LA, Wall M (1984) Small capsular hemorrhages. Clinical-computed tomographic correlations. Arch Neurol 41: 1255–1257Google Scholar
  27. 27.
    Chokroverty S, Rubino FA, Haller C (1977) Pure motor hemiplegia due to cerebral cortical infarction. Arch Neurol 34: 93–95Google Scholar
  28. 28.
    Gobernado JM, Fernandez de Molina AR, Gimeno A (1980) Pure motor hemiplegia due to hemorrhage in the lower pons. Arch Neurol 37: 393Google Scholar
  29. 29.
    Tapia JF, Kase CS, Sawyer RH, Mohr JP (1983) Hypertensive putaminal hemorrhage presenting as pure motor hemiparesis. Stroke 14: 505–506Google Scholar
  30. 30.
    Huang CY, Woo E, Yu YL, Chan FL (1987) When is sensory motor stroke a lacunar syndrome. J Neurol Neurosurg Psychiatry 50: 720–726Google Scholar
  31. 31.
    Kappelle LJ, Koudstaal PJ, Van Gijn J, Ramos LMP, Keunen JEE (1988) Carotid angiography in patients with lacunar infarction — a prospective study. Stroke 19: 1093–1096Google Scholar
  32. 32.
    Becker H, Desch H, Hacker H, Pencz A (1979) CT fogging effect with ischemic cerebral infarcts. Neuroradiology 18: 185–192Google Scholar
  33. 33.
    Fischer CM (1965) Lacunes: small deep cerebral infarcts. Neurology 15: 774–784Google Scholar
  34. 34.
    Kinkel PR, Kinkel WR, Jacobs L (1980) Clinical-computerized tomographic (CT) correlations of cerebral lacunes. Neurology 30: 44–45Google Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • L. J. Kappelle
    • 1
  • L. M. P. Ramos
    • 2
  • J. van Gijn
    • 1
  1. 1.Department of NeurologyUniversity Hospital UtrechtThe Netherlands
  2. 2.Department of RadiologyUniversity Hospital UtrechtThe Netherlands

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