Clinical and Radiologic Features of Lacunar Versus Nonlacunar Minor Stroke

Norrving, Bo MD
Cronqvist, Sten MD

From the Departments of Neurology and Neuroradiology, University HospitaJ, Lund, Sweden.

Address for correspondence: Bo Norrving, MD, Department of Neurology, University Hospital, S-221 85 Lund, Sweden.

Received April 20, 1988; accepted June 29, 1988.

Stroke 20(1):p 59-64, January 1989.

We determined the angiographic presence of extracerebral and intracerebral arterial disease in 122 patients with minor stroke within the carotid territory; we excluded patients with a recognized cardiac source of emboli. Based on clinical features and computed tomographic findings, patients were classified as having lacunar infarcts (n = 61), nonlacunar infarcts (n = 53), and infarcts of indeterminate type (n = 8). Severe carotid bifurcation disease (>50% stenosis or occlusion) was significantly more common in nonlacunar than in lacunar infarcts, on both the ipsilateral (p < 0.001) and the contralateral (p < 0.01) sides; 79% of the patients with nonlacunar infarcts had severe carotid bifurcation and/or middle cerebral artery disease on the ipsilateral side compared with 3.3% of the patients with lacunar infarcts. Our data underscore the need for classification of patients by the underlying mechanisms in future studies of treatment of ischemic stroke. (Stroke 1989;20:59–64)