A study of lacunar infarcts based on analysis of the main anatomopathological series in the literature
Introduction. There are few clinico-anatomopathological studies of lacunar infarcts (LI), because of the excellent functional prognosis and unlikelihood of death occurring whilst in hospital. Material and methods. We reviewed the 10 main anatomopathological series of LI in the literature. A personal contribution was made based on analysis of the LI analyzed in 50 consecutive autopsies of patients with cerebrovascular disease. A descriptive clinico-anatomopathological assessment was done. Cerebrovascular risk factors, associated neurological syndromes and causes of death were analyzed. Results. A total of 1,200 cases were analyzed in the 11 anatomopathological series. The most usual number of LI was between 2 and 5 per brain (6 series). The commonest topographical lesions found, in order of frequency, were: In the lenticular nucleus (9 series), thalamus (4 series) and frontal white matter (4 series). The main risk factor was arterial hypertension (AHT), which occurred in between 58% and 90%. The main clinical findings were: Pseudobulbar syndrome (6 series), pure motor hemiparesia (3 series) and clinically silent ischemia (2 series). The causes of death were mainly non-neurological and due to ischemic cardiopathy, sepsis and pulmonary embolism. Conclusions. LI are usually multiple, and topographically they are found at the level of the basal ganglia. AHT is the main cerebrovascular risk factor. The causes of death are usually non-neurological
Resultados El número de casos analizados en las 11 series anatomopatológicas es de 1.200. El número de IL más habitual se sitúa entre 2 y 5 por cerebro (6 series). La topografía lesional más habitual se localiza, por orden de frecuencia, en el núcleo lenticular (9 series), tálamo (4 series) y sustancia blanca frontal (4 series). El principal factor de riesgo es la hipertensión arterial (HTA), con una frecuencia que oscila entre el 58 y el 90%. Las principales manifestaciones clínicas son: el síndrome pseudobulbar (6 series), la hemiparesia motora pura (3 series) y la isquemia silente clínicamente (2 series). Las causas de mortalidad son mayoritariamente no neurológicas, y debidas a cardiopatía isquémica, sepsis y embolismo pulmonar.
Conclusiones Los IL suelen ser múltiples y de topografía a nivel de los ganglios de la base. La HTA es el principal factor de riesgo cerebrovascular. Las causas de mortalidad suelen ser principalmente no neurológicas
