Cavitation of deep lacunar infarcts in patients with first-ever lacunar stroke: a 2-year follow-up study with MR

Stroke. 2012 Aug;43(8):2245-7. doi: 10.1161/STROKEAHA.112.660076. Epub 2012 Jun 12.


Background and purpose: Studies in patients with lacunar stroke often assess the number of lacunes. However, data on how many symptomatic lacunar infarcts cavitate into a lacune are limited. We assessed the evolution of symptomatic lacunar infarcts over 2-year follow-up.

Methods: In 82 patients with first-ever lacunar stroke with a lacunar infarct in the deep brain regions (excluding the centrum semiovale), we performed a brain MR at presentation and 2 years later. We classified cavitation of lacunar infarcts at baseline and on follow-up MR as absent, incomplete, or complete. We recorded time to imaging, infarct size, and vascular risk factors.

Results: On baseline MR, 38 (46%) index infarcts showed complete or incomplete cavitation. Median time to imaging was 8 (0-73) days in noncavitated and 63 (1-184) days in cavitated lesions (P<0.05). On follow-up imaging, 94% of the lacunar infarcts were completely or incompletely cavitated, most had reduced in diameter, and 5 (6%) had disappeared. Vascular risk factors were not associated with cavitation.

Conclusion: Cavitation and lesion shrinkage were seen in almost all symptomatic lacunar infarcts in the deep brain regions over 2-year follow-up. Counting lacunes in these specific regions at a random moment might slightly, however not substantially, underestimate the burden of deep lacunar infarction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Basal Ganglia / pathology
  • Brain / pathology
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted
  • Internal Capsule / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pons / pathology
  • Risk Factors
  • Stroke, Lacunar / pathology*
  • Tomography, X-Ray Computed
  • Vascular Diseases / complications