Wednesday 23 November 2011

Lacunar infarct MRI

Clinically : 1 day history of right side weakness.
This MRI Brain diffusion show a recent lacunar infarct with restricted diffusion in the region of posterior limb of left internal capsule.


Lacunar infarcts are caused by small vessel occlusion (a single deep penetrating artery).

Occur in the deep grey nuclei of the brain (37% putamen, 14% thalamus, and 10% caudate) as well as the pons (16%) or the posterior limb of the internal capsule (10%).
Less commonly in the deep cerebral white matter, the anterior limb of the internal capsule, and the cerebellum.

The two proposed mechanisms are microatheroma and lipohyalinosis. Advanced age, chronic hypertension, smoking, diabetes mellitus elevated cholesterol, or history of prior stroke are the risk factors.

When no evidence of small vessel disease, an embolic cause is assumed from major artery or heart.

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