Brain Magnetic Resonance Imaging in the Evaluation of Patients with Lacunar Syndrome Compared with CT

ABSTRACT

The purpose of this study was to evaluate the efficiency of Magnetic Resonance Imaging (MRI) in the evaluation of patients with lacunar syndrome, to compare the sensitivity of MRI and that of brain Computed Tomography(CT) in the lacunar lesions. Thirty-nine cases of lacunar syndrome were pure sensory stroke(1 case), pure motor hemiparesis (12 cases), ataxic hemiparesis (5 cases), pure motor hemiparesis sparing face (2 case), pure motor hemiparesis with confusion (1 case), cerebellar ataxia with crossed 3rd nerve palsy (1 case), sensory-motor stroke(4 cases), lower basilar branch syndrome (6 cases), lateral medullary syndrome (3 cases), lateral pontomedullary syndrome (2 cases), locked-in syndrome (1 case), and miscellaneous (1 case). MRI detected small, deep lesions appropriate to lacunar syndrome in 34 cases (medulla, 3 cases; pons, 16 cases; midbrain, 3 cases : thalamus-internal capsule, 2 cases : internal capsule-basal ganglia, 6 cases; periventricular white matter, 3 cases) of the patients (34/39, 87.1%), and was diagnostically superior to CT in those cases (especially in brainstem lacunar lesions), where both studies were obtained concommitantly (MRI : CT=84.3% : 37.5%). MRI, when evailable, should replace CT as the diagnostic imaging procedure of choice in evaluation of lacunar syndrome.