Stroke, Vol 22, 1236-1241, Copyright © 1991 by American Heart Association
SE Sacco, JP Whisnant, JP Broderick, SJ Phillips and WM O'Fallon
BACKGROUND AND PURPOSE: This study evaluated the characteristics and
natural history of patients with lacunar (small, deep) cerebral infarcts in
a defined population for comparison of these characteristics to those in
patients with nonlacunar infarcts. METHODS: This is a population-based
study in Rochester, Minnesota, from 1960 to 1984, that used the medical
record-linkage system to identify and characterize patients with cerebral
infarction. RESULTS: The age- and sex-adjusted average annual incidence
rate of lacunar cerebral infarction was 13.4/100,000 persons, accounting
for 12% of all first cerebral infarcts. Temporal trends in incidence rates,
stroke recurrence rates, prevalence of diabetes mellitus, and causes of
death (given survival for 30 days) for cases of lacunar infarction were not
significantly different from those for cases of nonlacunar infarction.
Hypertension was found in 81% of patients who had a lacunar infarct and in
70% of patients who had a nonlacunar infarct (p = 0.05). A potential
cardiac source of embolism was found in 12% of patients who had a lacunar
infarct and in 28% of patients who had a nonlacunar infarct (p = 0.002).
Survival was significantly better after a lacunar infarct than after a
nonlacunar infarct. CONCLUSIONS: Small, deep cerebral infarcts had many of
the epidemiological characteristics of other cerebral infarcts but there
was a slightly higher frequency of hypertension, significantly lower
frequency of a cardiac embolic source, and significantly better survival in
patients with lacunar infarction than in those with nonlacunar infarction.
ARTICLES
Epidemiological characteristics of lacunar infarcts in a population
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
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