ATHEROSCLEROSIS RISK FACTORS AND ETIOLOGIC MECHANISMS OF LACUNAR STROKE

Introduction: it is thought that lacunae occur in patients with hypertension or diabetes mellitus as small-vessel involvement. the frequency of other stroke mechanisms in patients with lacunae was evaluated in this study.methods: consecutive stroke patients admitted to valie-asr hospital, khorasan in 2006 were enrolled in a prospective study. diagnosis of stroke and its risk factors was made by a stroke neurologist. all of the stroke patients underwent a standard battery of diagnostic investigations. brain infarction was categorized as lacunae and large-vessel territory infarction (lvti). chi-square test and odds ratios were used for statistical analysis.results: ninety-six patients with lacunae and 252 patients with lvti were studied.the frequency of diabetes and hypercholesterolemia was significantly higher in patients with lacunar stroke than in those with lvti (p=0.034 and p<0.001, respectively). the frequency of hypertension, smoking, transient ischemic attacks (tia) and ipsilateral carotid stenosis was not significantly different between the two groups (p=0.94, p=0.59, p=0.37 and p=0.13, respectively). atrial fibrillation was significantly more frequent in patients with lvti (p<0.001). the frequency of various etiologic mechanisms was not significantly different in lacunar stroke and lvti patients (df=4, p=0.164).conclusions: hypertension in patients with lacunar stroke is not more frequent than in other stroke patients. cardioembolism and artery-to-artery embolism are important but less common mechanisms of lacunae.