Availability of Classification of Lacunar Syndrome and Diffusion-weighed MR Imaging in Lacunar Stroke

Ryu,  Seung; Kim,  Hoon; Park,  Jeong Su; Chung,  Sung Pil; Kim,  Seung Whan; Yoo,  In Sool

J Korean Soc Emerg Med > Volume 14(4); 2003 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2003;14(4): 360-365.

Availability of Classification of Lacunar Syndrome and Diffusion-weighed MR Imaging in Lacunar Stroke

Seung Ryu, Hoon Kim, Jeong Su Park, Sung Pil Chung, Seung Whan Kim, In Sool Yoo

Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea. mdinsool@cnuh.co.kr

ABSTRACT

PURPOSE:
This study was performed to evaluate the availability of classification of lacunar syndrome and of diffusion weighted MRI as initial diagnostic tools for patients with lacunar syndrome.
METHODS:
From January 1 to October 31, 2001, we prospectively studied patients presenting with lacunar syndrome. All patients were scanned using diffusion-weighted MRI and were then classified into categories based on the diagnosis pure motor stroke and ataxic hemiparesis, sensory motor stroke, pure sensory stroke, dysarthria-clumsy hand syndrome, and others.
RESULTS:
The total number of patents was 72 ; 60 cases of lacunar infarcts and 12 cases of lacunar hemorrhage. There were 42 cases of pure motor stroke and ataxic hemiparesis, 17 cases of sensory motor stroke, 8 cases of dysarthria-clumsy hand syndrome, 3 cases of pure sensory stroke, 2 cases of others. Lacunar syndrome can be caused by lesions in a variety of locations, and specific location can cause a variety of lacunar syndromes. With diffusion-weighted MRI, lacunar syndromes were visible in 91.7% of the patients (66/72) and lacunar infarcts were visible in 90% (54/60). The mean size of the lacunar infarcts was 11.90+/-5.04 mm and the mean volume of lacunar hemorrhages was 4.70+/-2.08 ml.
CONCLUSION:
This study showed that the classification of lacunar syndrome was of little benefit in the diagnosis and treatment of a lacunar infarct. Diffusion-weighted MRI, however, was a good initial diagnostic tool in cases of lacunar infarcts. An additional study of the availability of diffusion weighted MRI for use in cases of hemorrhagic lesions is needed.

Key words: Diffusion, infarction, Magnetic resonance imaging