Revista de la Facultad de Medicina (Jan 1981)
Lagunas cerebrales: estudio clínico y patológico de 100 casos fatales
Abstract
A review of neurologic autopsies from the Hopital de la Salpetriere (Paris), from 1964 to 1974, yielded 100 patients with lacunes for which complete clinical records ware available. Lacunes were found to be lesions of senescence (mean age 67 years), without sex preference, usually multiple (72 cases), that present most commonly in the basal ganglia and the pons. They are reliable indicators of cerebrovascular disease since they were accompanied by cerebral infarctions involving large arterial territories in 50 patients and cerebral hemorrhage in 32. Moderate to severe cerebral atherosclerosis was found in 85%. The majority of patients had longstanding arterial hypertension but in 28% there was no clinical nor pathologic evidence of hypertension. These patients were older (mean age 72 years than hypertensive ones (mean age 64 years). Diabetes was present in only 9 cases. Solitary lacunes usually were asymptomatic in 26 patients. Multiple lacunes on the contrary presented as pseudobulbar palsy in 18 patients or were associated with dementia in 36 cases, mostly with multi-infarct dementia, although six patients had Alzheimer's disease and six more had Binswanger's disease. In 16 patients with-infarct dementia, multiple lacunes were associated with ventricular dilatation, a finding that might be significant in vies of the recent association of normal pressure hydrocephalus and état lacunaire
