Occlusive disease of small penetrating arteries

Abstract

From 1965, Fisher studied small, deep infarcts and described the classical lacunar syndromes as the result of penetrating artery occlusion. It is now known that most lacunar infarcts occur within the lenticulostriate, thalamoperforators, and pontine paramedian arterial territories. Lacunar infarcts are usually due to occlusion of a single penetrating artery. This chapter presents epidemiology, pathophysiology, clinical features, investigations and treatment for occlusive disease of small penetrating arteries. Traditionally, lacunar infarction has been associated with five clinical syndromes. Magnetic resonance imaging (MRI) has been shown to be more sensitive than CT in the diagnosis of stro..