Clinical and radiologic features of lacunar versus nonlacunar minor stroke

Abstract

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. © 1988 American Heart Association, Inc.