To Study the Incidence of Lacunar Infarcts in Patients with Acute Ischemic Stroke and its Correlation with Carotid Artery Stenosis

Abstract

Introduction: Stroke remains the second leading cause of death worldwide, after ischemic heart disease. Lacunar infarcts are small deep infarcts ranging from 2 to 20 mm in size resulting from occlusion of a penetrating artery which accounts for approximately 25% of all ischemic strokes. The present study was undertaken to study the incidence of lacunar infarcts in patients with acute ischemic stroke and its correlation with carotid stenosis. Materials and methods:This study was performed at the Department of Medicine at a tertiary-care hospital in Amritsar, Punjab, in 50 patients presenting with acute ischemic stroke with or without lacunar syndrome. All patients were diagnosed using diffusion-weighted imaging (DWI) on magnetic resonance imaging (MRI) of the brain. Carotid artery stenosis was measured with duplex ultrasound. Results:Patients with acute ischemic stroke had a mean age of 61.36 ± 11.36 years. About 40% of the patients had lacunar infarcts with a higher frequency in male patients (64% vs 36%). There was no significant difference found in the incidence of hypertension (85% vs 70%), diabetes (20% vs 13.3%, p value = 0.529), alcohol drinking (20% vs 16.67.0%, p value = 0.764), smoking (23% vs 10% p value = 0.318), and carotid artery stenosis (35% vs 43.3%, p value = 0.828) between lacunar and non-lacunar infarct patients. Conclusion:The difference in the incidence of potential risk factors such as hypertension, diabetes mellitus, alcoholism, smoking, and dyslipidemia was found to be statistically insignificant between lacunar and non-lacunar infarct groups. Carotid stenosis did not show any significant difference in the lacunar and non-lacunar infarct groups. The findings in our study are consistent with the hypothesis that severe carotid artery stenosis in lacunar infarction is an incidental finding.