Skip to main content
SpringerLink
Log in

Significance of haemorrhagic lacunes on MRI in patients with hypertensive cerebrovascular disease and intracerebral haemorrhage

  • Diagnostic Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Our purpose was to determine the frequency and signifcance of haemorrhagic lacunes (HL) on MRI in patients with a history of, or at risk for intracerebral haemorrhage. We examined 72 patients with old spontaneous intracerebral haemorrhage (ICH) using T1-and T2-weighted spin-echo sequences. MRI studies of 137 consecutive patients with cerebrovascular disease but no known ICH were also reviewed. Both groups showed about the same degree of age-related white matter change and nonhaemorrhagic lacunar infarcts, whereas the ICH group had a higher frequency of HL (12/72 patients) than the non-ICH group (6/131 patients,p<0.01). These results correlate well with reported pathological findings. We conclude that haemorrhagic lacunes found on MRI studies of patients with cerebrovascular disease may suggest a higher risk of intracerebral haemorrhage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fisher CM (1971) Pathological observations in hypertensive cerebral hemorrhage. J Neuropathol Exp Neurol 30: 536–550

    Google Scholar 

  2. Fisher CM (1965) Lacunes: small, deep cerebral infarcts. Neurology 15: 774–784

    Google Scholar 

  3. Zeumer H, Schonsky B, Sturm KW (1980) Predominant white matter involvement in subcortical arteriosclerotic encephalopathy (Binswanger disease). J Comput Ass Tomogr 4: 14–19

    Google Scholar 

  4. Ringelstein EB, Zeumer H, Schneider R (1985) Der Beitrag der zerebralen Computertomographie zur Differentialtypologie und Differentialtherapie des ischämischen Großhirninfarktes. Fortschr Neurol Psychiat 53: 315–336

    Google Scholar 

  5. Millikan C, Futrell N (1990) The fallacy of the lacune hypothesis. Stroke 20: 1251–1257

    Google Scholar 

  6. Bamford JM, Warlow CP (1988) Evolution and testing of the lacunar hypothesis. Stroke 19: 1074–1082

    Google Scholar 

  7. Landau WM (1989) Au clair de lacune: Holy, wholly, holey logic. Neurology 39: 725–730

    Google Scholar 

  8. Rothrock JF, Lyden PD, Hesselink JR, Brown JJ, Healy ME (1987) Brain magnetic resonance imaging in the evaluation of lacunar stroke. Stroke 18: 781–786

    Google Scholar 

  9. Kertesz A, Black SE, Nicholson L, Carr T (1987) The sensitivity and specificity of MRI in stroke. Neurology 37: 1580–1585

    Google Scholar 

  10. Gomori JM, Grossman RI, Steiner I (1988) High-field magnetic resonance imaging of intracranial hematomas. Isr J Med Sci 24: 218–223

    Google Scholar 

  11. Sipponen JT, Sepponen RE, Sivula A (1983) Nuclear magnetic resonance (NMR) imaging of intracerebral hemorrhage in the acute and resolving phases. J Compt Ass Tomogr 7: 954–959

    Google Scholar 

  12. Gomori JM, Grossman RI, Goldberg HI, Zimmerman RA, Bilaniuk LT (1985) Intracranial hematomas: imaging by highfield MR. Radiology 157: 87–93

    Google Scholar 

  13. Atlas SW, Grossman RI, Gomori JM, Hackney DB, Goldberg HI, Zimmerman RA, Bilaniuk LT (1987) Hemorrhagic intracranial malignant neoplasms: spin-echo MR imaging. Radiology 164: 71–77

    Google Scholar 

  14. Winkler ML, Olsen WL, Mills TC, Kaufman L (1987) Hemorrhagic and nonhemorrhagic brain lesions: evaluation with 0.35 T fast MR imaging. Radiology 165: 203–207

    Google Scholar 

  15. Hackney DB, Atlas SW, Grossman RI, Gomori JM, Goldberg HI, Zimmerman RA, Bilaniuk LT (1987) Subacute intracranial hemorrhage: contribution of spin density to appearance on spin-echo MR images. Radiology 165: 199–202

    Google Scholar 

  16. DeLaPaz RL, New PF, Buonanno FS, Kistler JP, Oot RF, Rosen BR, Taveras JM, Brady TJ (1984) NMR imaging of intracranial hemorrhage. J Compt Ass Tomogr 8: 599–607

    Google Scholar 

  17. Sipponen JT, Sepponen RE, Tanttu JI, Sivula A (1985) Intracranial hematomas studied by MR imaging at 0.17 and 0.02 T. J Compt Ass Tomogr 9: 698–704

    Google Scholar 

  18. Challa VR, Moody DM (1989) The value of magnetic resonance imaging in the detection of type II hemorrhagic lacunes. Stroke 20: 822–825

    Google Scholar 

  19. Awad IA, Spetzler RF, Hodak JA, Awad CA, Carey R (1986) Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I. Correlation with age and cerebrovascular risk factors. Stroke 17: 1084–1089

    Google Scholar 

  20. DeWitt LD (1985) Clinical use of nuclear magnetic resonance imaging in stroke. Stroke 17: 328–331

    Google Scholar 

  21. Awad I, Modic M, Little JR, Furlan AJ, Weinstein M (1986) Focal parenchymal lesions in transient ischemic attacks: correlation of computer tomography and magnetic resonance imaging. Stroke 17: 399–403

    Google Scholar 

  22. Gomori JM, Grossman RI (1988) Mechanisms responsible for the MR appearance and evolution of intracranial hemorrhage. Radio Graphics 8: 427–440

    Google Scholar 

  23. Thulborn KR, Sorensen AG, Kowall NW, McKee A, Lai A, McKinstry RC, Moore J, Rosen BR, Brady TJ (1990) The role of ferritin and hemosiderin in the MR appearance of hemorrhage: a histopathologic biochemical study in rats. AJNR 11: 219–297

    Google Scholar 

  24. Stehbens WE (1972) Intracerebral and intraventricular hemorhage. In: Pathology of the cerebral blood vessels. Mosby, St. Louis, pp 284–318

    Google Scholar 

  25. Poirier J, Gray F, Gherardi R, Derouesne C (1985) Cerebral lacunae: a new neuropathological classification. (abstract). Neuropathol Exp Neurol 44: 312

    Google Scholar 

  26. Gomori JM, et al. (1986) Occult cerebrovascular malformations: high field MRI. Radiology 158: 707–713

    Google Scholar 

  27. Drayer B, et al. (1986) MRI of brain iron. AJNR 7: 337–380

    Google Scholar 

  28. Yates PO (1976) The central nervous system in hypertensive vascular disease. In: Blackwood W, Corsellis JAN (eds) Greenfield's Neuropathology 3rd edn., pp 125–140

  29. Bogousslavasky J, Van Melle G, Regli F (1988) The Lausanne Stroke Registry: analysis of 10,000 consecutive patients with first stroke. Stroke 19: 1083–1092

    Google Scholar 

  30. Mutlu N, Berry RG, Alpers BJ (1963) Massive cerebral hemorrhage. Arch Neurol 8: 644–661

    Google Scholar 

  31. McCormick WF, Rosenfield DB (1973) Massive brain hemorrhage: a review of 144 cases and an examination of their causes. Stroke 4: 946–954

    Google Scholar 

  32. Hungerbühler JP, Regli F, Van Melle G, Bogousslavsky J (1983) Spontaneous intracerebral haemorrhages (SICHs): clinical and CT features; immediate evaluation of prognosis. Arch Suisses Neurol Neuroch Psych 132: 13–27

    Google Scholar 

  33. Brott T, Thalinger K, Herzberg V (1986) Hypertension as a risk factor for spontaneous intracerebral hemorrhage. Stroke 6: 1078–1083

    Google Scholar 

  34. Awad IA, Johnson PC, Spetzler RF, Hodak JA (1986) Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. II. Postmortem pathological correlations. Stroke 17: 1090–1097

    Google Scholar 

  35. Braffman BHZ, Zimmerman RA, Trojanowski JQ, Gonatas NK, Hickey WF, Schlaepfer WW (1988) Brain MR: pathologic correlation with gross and histopathology. 2. Hyperintense white-matter foci in the elderly. AJNR 9: 629–636

    Google Scholar 

  36. Inzitari D, Giordano GP, Ancona AL, Pracucci G, Mascalchi M, Amaducci L (1990) Leukoaraiosis, intracerebral hemorrhage, and arterial hypertension. Stroke 21: 1419–1423

    Google Scholar 

  37. Hijdra A, Verbeeten B, Verhulst J (1990) Relation of leukoaraiosis to lesion type in stroke patients. Stroke 21: 890–894

    Google Scholar 

  38. Russel RWR (1984) Pathological changes in small cerebral arteries causing occlusion and haemorrhage. J Cardiovasc Pharmacol 6: 691–695

    Google Scholar 

  39. Cross PA, Atlas SW, Grossman RI (1990) MR evaluation of brain iron in children with cerebral infarction. AJNR 11: 341–348

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neuroradiology, University of Heidelberg Medical School, Heidelberg, Germany

    J. Scharf, E. Bräuherr, M. Forsting & K. Sartor

Authors
  1. J. Scharf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Bräuherr
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Forsting
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Sartor
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scharf, J., Bräuherr, E., Forsting, M. et al. Significance of haemorrhagic lacunes on MRI in patients with hypertensive cerebrovascular disease and intracerebral haemorrhage. Neuroradiology 36, 504–508 (1994). https://doi.org/10.1007/BF00593508

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00593508

Key words

Search

Navigation