Progressive Lacunar lnfarcts: Risk Factors and Clinical Properties

Abstract

Purpose: The aim of this study is to investigate the clinical features and risk factors of the patients with lacunar infarcts who have progressive motor deficits. Patients and Method: 13 consecutive patients admitted to Neurology Clinic of Trakya University Medical Faculty with the diagnosis of first stroke having single supratentorial lacunar infarct detected by MRI or CT, and progressive motor deficit, on 1 January 2000-31 December 2001 were enrolled in this study. Clinical characteristics, and risk factors, therapy, localization of the lacunar infarct of these patients were registered. They were compared with 13 cases with lacunar infarcts who have stable motor deficit. Results: Maximum motor deficit has developed in patients with progressive lacunar infarcts in mean 37.4± 23.1 hours and maximum in 4 days. Lacuna was found in capsula intema, corona radiata and thalamus in 6, 6 and 1 patients respectively and the median lacuna diameter was 1.38±0. 16 cm. Smoking was detected in five patiens (%38), hypertension was detected in 10 patients (%76) and Diabetes Mellitus was detected in 7 patients (%53). The median cholesterol level was found as 187 ±62 mg/dl. When the risk factors were compared with the 13 patients with stable lacunar infarcts no difference was found in the view of hypertension, smoking and cholesterol level. The presence of DiabetesMellitus was found in higher rate in the group of patients with progressive lacunar infarcts than the ones with stable motor deficit. Conclusion: Diabetes Mellitus can be a risk factor for the progression of motor deficit in the patients with lacunar infarct.