Hemorrhagic lacunar stroke

A total of 17 patients with lacunar syndromes due to intracerebral hemorrha ge or hemorrhagic lacunar stroke (pure motor hemiparesis 9, sensorimotor st roke 5, pure sensory stroke 3) are reported. Data from these patients were obtained from consecutive stroke patients included in the prospective Hospi tal Sagrat Cor-Alianca Stroke Registry. Hemorrhagic lacunar stroke accounte d for 3.8% of all cases of lacunar syndrome (n = 439) and 7.4% of all cases of intracerebral hemorrhage (n = 229) entered in the database. Demographic , anamnestic, clinical and neuroimaging variables in patients with hemorrha gic lacunar stroke, non-lacunar intracerebral hemorrhage and non-hemorrhagi c lacunar stroke were compared. Predictors of hemorrhagic lacunar stroke we re assessed by logistic regression analysis. Hypertension, cigarette smokin g and involvement of the internal capsule were significantly more frequent in patients with hemorrhagic lacunar stroke than in those with non-lacunar intracerebral hemorrhage, whereas nausea and vomiting, altered consciousnes s, speech disturbances, hemianopia, and ventricular hemorrhage were signifi cantly less frequent. As compared with non-hemorrhagic lacunar stroke, pati ents with hemorrhagic lacunar stroke were more likely to have hypertension, sudden stroke onset (minutes), head injury, headache, and basal ganglia in volvement and less likely to have diabetes, gradual stroke onset (hours), a nd dysarthria. After multivariate analysis, only headache (OR 10.14), sudde n onset (OR 9.89), and dysarthria (OR 0.10) were independent predictors of hemorrhagic lacunar stroke. Accordingly, the presence of headache and sudde n onset of symptoms and absence of dysarthria may be useful signs for disti nguishing hemorrhagic lacunar stroke from other causes of lacunar stroke. C opyright (C) 2000 S. Karger AG, Basel.