Introduction: There are few clinico-anatomopathological studies of lacunar infarcts (LI), because of the excellent functional prognosis and unlikelihood of death occurring whilst in hospital.
Material and methods: We reviewed the 10 main anatomopathological series of LI in the literature. A personal contribution was made based on analysis of the LI analyzed in 50 consecutive autopsies of patients with cerebrovascular disease. A descriptive clinico-anatomopathological assessment was done. Cerebrovascular risk factors, associated neurological syndromes and causes of death were analyzed.
Results: A total of 1,200 cases were analyzed in the 11 anatomopathological series. The most usual number of LI was between 2 and 5 per brain (6 series). The commonest topographical lesions found, in order of frequency, were: In the lenticular nucleus (9 series), thalamus (4 series) and frontal white matter (4 series). The main risk factor was arterial hypertension (AHT), which occurred in between 58% and 90%. The main clinical findings were: Pseudobulbar syndrome (6 series), pure motor hemiparesia (3 series) and clinically silent ischemia (2 series). The causes of death were mainly non-neurological and due to ischemic cardiopathy, sepsis and pulmonary embolism.
Conclusions: LI are usually multiple, and topographically they are found at the level of the basal ganglia. AHT is the main cerebrovascular risk factor. The causes of death are usually non-neurological.