The arterial lesions underlying lacunes

@article{Fisher2004TheAL,
  title={The arterial lesions underlying lacunes},
  author={C. Miller Fisher},
  journal={Acta Neuropathologica},
  year={2004},
  volume={12},
  pages={1-15}
}
  • C. Fisher
  • Published 1 March 1969
  • Medicine
  • Acta Neuropathologica
SummaryThe arterial lesions causing lacunes have been investigated using serial sections of blocks of the basal ganglia and pons from four cases with a history of hypertension and small strokes.In 45 of 50 consecutive lacunes there was a total occlusion of the artery supplying the territory of the infarct. The associated vascular lesions were as follows: segmental arterial disorganization 40 (with enlargement 31, with hemorrhage 26, with fibrinoid deposit 14), thrombosis of a fusiform… 
Lacunar Infarction and Small Vessel Disease: Pathology and Pathophysiology
  • L. Caplan
  • Medicine, Biology
    Journal of stroke
  • 2015
Two major vascular pathologies underlie brain damage in patients with disease of small size penetrating brain arteries and arterioles; 1) thickening of the arterial media and 2) obstruction of the
Lacunar Infarction Embolism is the Key
TLDR
The literature demonstrates that emboli are the cause of lacunes, and the hypothesis that hypertension or diabetes causes lacunes is not supported, and there is no animal data to support the standard lacune hypothesis.
New Concepts in Lacunar Stroke Etiology: The Constellation of Small-Vessel Arterial Disease
TLDR
LI is an ischemic stroke subtype with a characteristic clinical presentation and a short-term favorable prognosis, and may be caused, in less than 5% of cases, by various etiologies, mainly hematological diseases and infectious or inflammatory arteritis.
Lacunar versus non-lacunar syndromes.
TLDR
These findings suggest that lacunar stroke is not always a benign disease, and clinical features may be significant in terms of disability in lacunae in close proximity to crucial anatomical site.
Expanding Cerebellar Lacunes Due to Dilatation of the Perivascular Space Associated With Binswanger's Subcortical Arteriosclerotic Encephalopathy
TLDR
An 80-year-old hypertensive woman developed right hemiplegia and died 24 hours after admission, and multiple cerebral infarcts of various ages and diffuse subcortical arteriosclerotic encephalopathy were revealed, suggesting a common pathophysiologic mechanism possibly including an alteration of the blood-brain barrier.
Should patients with lacunar stroke and severe carotid artery stenosis undergo endarterectomy?
TLDR
The concept of lacunar infarction has been long recognized, but it was Fisher who first drew attention to the association with distinct clinical syndromes, and the evidence that patients with LI are likely to benefit from this procedure is searched.
Spuriously Large Subcortex Infarct due to Confluent Smaller Lesions: A Diffusion-Weighted MRI/CT Study
TLDR
A case with two small lacunes seen on diffusion-weighted MRI that merged to form a giant lacunar infarct seen on CT is reported, which is believed to provide CT documentation of the pathogenesis of giant Lacunar Infarcts.
Lacunar Infarction
TLDR
Several studies using diffusion-weighted MRI (dwMRI) show that a small subcortical ischemic area corresponding to the territory of a penetrating artery is the most common finding, being present in 84% to 94% of patients with a lacunar syndrome.
Distribution of lacunes in cerebral amyloid angiopathy and hypertensive small vessel disease
TLDR
Lobar lacunes seem to have a close relationship with WMH, suggesting a possible common origin, and lobar lacunes are associated with CAA, whereas deep Lacunes are more frequent in HTN-SVD.
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References

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TLDR
While it was possible to correlate lacunes with the occurrence of cerebral atherosclerosis and arterial hypertension, the clinical details in the cases were so deficient that a good clinicopathologic correlation could not be made.
Hypertensive fibrinoid arteritis of the brain and gross cerebral hemorrhage: a form of "hyalinosis".
TLDR
The infarct, an area of necrosis due to ischemia, may be associated with a varying degree of hemorrhage in the form of isolated or confluent petechiae, and this hemorrhage may be minimal, moderate, or severe in degree.
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TLDR
In der Lehre yon der hypertonischen apoplektischen t t irnblutung (h. a .H. a.) stehen sieh die Ansichten nach wie vor sehroff gegeniiber, sollen die Ergebnisse dieser Arbeit zeigen.
Die Gehirngefäße beim Hochdruck
Einleitung. Im folgenden soll der Einflul~ einer liinger dauernden Hypertonie auf die Gehirngefi~e untersucht werden. Wir werden uns fragen: welche Ver~nderungen verursacht der Hochdruck an den
Zur Lehre von der Entstehung des Schlaganfalles
Über die Entstehung der Hirnblutung bei dem Schlaganfall
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  • Medicine
    Deutsche Zeitschrift für Nervenheilkunde
  • 2005
Lacunes: SmM1 deep cerebral infarcts
  • Neurology (Minneap.) 15, 774
  • 1965
OBSERVATIONS ON INTRACEREBRAL ANEURYSMS.
PnosE : Hypertensive fibrinoid arteritis of the brain and gross cerebral hemorrhage
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