EXPANDING CEREBRAL LACUNAE - AN ELECTROPH YSIOLOGICAL APPROACH

A 42-year-old man was affected with multiple cerebral lesions suggesti ng expanding lacunae. He had suffered for about 15 years of headaches and blurred vision. Neurological examination showed a Parinaud syndrom e and a skew deviation. Magnetic resonance imaging showed an enlargeme nt of the third and lateral ventricles and multiple intraparenchymatou s lesions with a signal similar to that of the cerebrospinal fluid. Th ese lesions were located in the mesencephalon and right thalamic regio n. Important discrepancies between the topography of the lesion and th e clinical data were observed. Neurological examination, ocular moveme nts study and auditory evoked potentials are in favor of a ponto-mesen cephalic lesion. Spectral analysis during wake and neuropsychological testing suggested sub-cortical dysfunction. These results suggest func tional rather than lesional repercussion of expansive lacunae.