The classic lacunar syndromes: clinical and neuroimaging correlates

Background: Although lacunar syndromes (LSs) are aimed to be linked to lacunar infarcts, the relation between both is still not very well defined. Purpose: The present retrospective study tries to de. ne more specifically the clinical and the neuroimaging characteristics of the five most classic LSs. Patients and methods: Out of a series of 1617 consecutive stroke patients, admitted to the Ghent University Hospital, 293 presented a classic LS. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) was performed within 5 days after stroke onset in 227 patients. An acute territorial infarct was demonstrated in 54 patients. The study population finally consisted of 173 patients with a classic LS in whom the responsible lacune was demonstrated or in the absence of another type of infarct. Results: The responsible lacune was demonstrated with DWI in 104 patients. Pure motor stroke ( MS) correlated significantly with the presence of the responsible lacune in the internal capsule (P = 0.000147) and with the stroke severity (P = 0.00724). No significant correlation was observed between the location of the lacunes and the other LS's. Conclusion: Pure MS has to be considered as the most specific lacunar syndrome.