The arterial lesions underlying lacunes

There was a total occlusion of the artery supplying the territory of the infarct in 45 of 50 consecutive lacunes, and segmental arterial disorganization has been discussed in some detail.

Abstract

The arterial lesions causing lacunes have been investigated using serial sections of blocks of the basal ganglia and pons from four cases with a history of hypertension and small strokes. In 45 of 50 consecutive lacunes there was a total occlusion of the artery supplying the territory of the infarct. The associated vascular lesions were as follows: segmental arterial disorganization 40 (with enlargement 31, with hemorrhage 26, with fibrinoid deposit 14), thrombosis of a fusiform asymmetric microaneurysm, 2; plaque of foam cells (atherosclerosis) 3; complete absence of any lesion 1; suspected segmental disorganization 3; and miscellaneous 1. Segmental arterial disorganization has been discussed in some detail. Others have termed this condition hyalinosis, angionecrosis with aneurysm formation, plasmatic destruction, fibrinoid necrosis, fibrinoid arteritis, etc.