(Stroke. 1999;30:2066-2069.)
© 1999 American Heart Association, Inc.
Original Contributions |
Diffusion-Weighted MRI in Acute Lacunar Syndromes
A Clinical-Radiological Correlation Study
From the Department of Neurology, Clinica Rotger, Palma de Mallorca, Spain (W.J.S.); and the Departments of Neurology (S.T.) and Neuroradiology (M.B.S., S.W.A.), Mount Sinai Hospital, New York, NY.
Correspondence to Stanley Tuhrim, MD, Mount Sinai School of Medicine, Department of Neurology, Box 1137, One Gustave L. Levy Place, New York, NY 10029. E-mail S_Tuhrim{at}mssm.edu
Background and Purpose—Clinical-radiological correlation studies in lacunar syndromes have been handicapped by the low sensitivity of CT and standard MRI for acute small-vessel infarction and their difficulty in differentiating between acute and chronic lesions.
Methods—We prospectively studied 43 patients presenting with a classic lacunar syndrome using diffusion-weighted MRI, a technique with a high sensitivity and specificity for acute small-vessel infarction.
Results—All patients were scanned within 6 days of stroke onset. An acute infarction was identified in all patients. Pure motor stroke was associated with lesions in the posterior limb of the internal capsule (PLIC), pons, corona radiata, and medial medulla; ataxic hemipareses with lesions in the PLIC, corona radiata, pons, and insular cortex; sensorimotor stroke with lesions in the PLIC and lateral medulla; dysarthria–clumsy hand syndrome with lesions in the PLIC and caudate nucleus; and pure sensory stroke with a lesion in the thalamus. Supratentorial lesions extended into neighboring anatomic structures in 48% of the patients.
Conclusions—Lacunar syndromes can be caused by lesions in a variety of locations, and specific locations can cause a variety of lacunar syndromes. Extension of lesions into neighboring structures in patients with lacunar syndromes appears to be more frequent than previously described in studies using CT and standard MRI.
Key Words: diffusion • lacunar infarction • magnetic resonance imaging • stroke, acute
This article has been cited by other articles:
 |
|
 |
|
  A. Hiraga, A. Uzawa, and I. Kamitsukasa Diffusion weighted imaging in ataxic hemiparesis J. Neurol. Neurosurg. Psychiatry, November 1, 2007; 78(11): 1260 - 1262. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S P Chung, H S Chung, S Rhu, S W Kim, I S Yoo, J Kim, and C J Song Emergency department experience of primary diffusion weighted magnetic resonance imaging for the patient with lacunar syndrome. Emerg. Med. J., September 1, 2006; 23(9): 675 - 678. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. V. Immink, G. A. van Montfrans, J. Stam, J. M. Karemaker, M. Diamant, and J. J. van Lieshout Dynamic Cerebral Autoregulation in Acute Lacunar and Middle Cerebral Artery Territory Ischemic Stroke Stroke, December 1, 2005; 36(12): 2595 - 2600. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Inatomi, K. Kimura, T. Yonehara, S. Fujioka, and M. Uchino DWI abnormalities and clinical characteristics in TIA patients Neurology, February 10, 2004; 62(3): 376 - 380. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Devuyst and J. Bogousslavsky Editorial Comment: The Fall and Rise of Lacunar Infarction With Carotid Stenosis Stroke, June 1, 2003; 34(6): 1409 - 1411. [Full Text] [PDF]
|
|
|
|
|
|
R. P. Gerraty, M. W. Parsons, P. A. Barber, D. G. Darby, P. M. Desmond, B. M. Tress, and S. M. Davis Examining the Lacunar Hypothesis With Diffusion and Perfusion Magnetic Resonance Imaging Stroke, August 1, 2002; 33(8): 2019 - 2024. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J J Marx, A Mika-Gruettner, F Thoemke, S Fitzek, C Fitzek, G Vucurevic, P P Urban, P Stoeter, and H C Hopf Diffusion weighted magnetic resonance imaging in the diagnosis of reversible ischaemic deficits of the brainstem J. Neurol. Neurosurg. Psychiatry, May 1, 2002; 72(5): 572 - 575. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Golomb, S. K. Weiss, S. H. Ibrahim, and G. A. deVeber A 15-Year-Old Boy With Central Nervous System Vasculopathy Presenting With Dysarthria-Clumsy Hand Syndrome J Child Neurol, March 1, 2002; 17(3): 241 - 243. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Rovira, A. Rovira-Gols, S. Pedraza, E. Grive, C. Molina, and J. Alvarez-Sabin Diffusion-Weighted MR Imaging in the Acute Phase of Transient Ischemic Attacks AJNR Am. J. Neuroradiol., January 1, 2002; 23(1): 77 - 83. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Morecraft, J. L. Herrick, K. S. Stilwell-Morecraft, J. L. Louie, C. M. Schroeder, J. G. Ottenbacher, and M. W. Schoolfield Localization of arm representation in the corona radiata and internal capsule in the non-human primate Brain, January 1, 2002; 125(1): 176 - 198. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Derex, T. A. Tomsick, T. G. Brott, C. A. Lewandowski, M. R. Frankel, W. Clark, S. Starkman, J. Spilker, G. J. Udsten, J. Khoury, et al. Outcome of Stroke Patients without Angiographically Revealed Arterial Occlusion within Four Hours of Symptom Onset AJNR Am. J. Neuroradiol., April 1, 2001; 22(4): 685 - 690. [Abstract] [Full Text]
|
|
|
|
|
|
S. L. Keir and J. M. Wardlaw Systematic Review of Diffusion and Perfusion Imaging in Acute Ischemic Stroke Stroke, November 1, 2000; 31(11): 2723 - 2731. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Lee, C. S. Kidwell, J. Alger, S. Starkman, and J. L. Saver Impact on Stroke Subtype Diagnosis of Early Diffusion-Weighted Magnetic Resonance Imaging and Magnetic Resonance Angiography Stroke, May 1, 2000; 31(5): 1081 - 1089. [Abstract] [Full Text] [PDF]
|
|