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J Neurol Neurosurg Psychiatry 2004;75:1375 doi:10.1136/jnnp.2004.046748
  • Multiple lacunar infarct mechanisms
  • Editorial commentary

Are multiple acute small subcortical infarctions caused by embolic mechanisms?

  1. B Norrving
  1. Department of Clinical Neuroscience, Lund University Hospital, Sweden
  1. Correspondence to:
 Dr B Norrving
 Department of Neurology, Lund University Hospital, Lund S-22185, Sweden; bo.norrvingneurol.lu.se

    Multiple lacunar infarct mechanisms

    In this issue the paper by Chowdhury et al (see page 1416)1 is an important addition to the list of recent publications that challenge traditional concepts on the mechanisms of acute ischaemic stroke. According to conventional teaching, an acute ischaemic stroke is characterised by infarction confined to a single localised (focal) region of the brain. However, new neuroimaging techniques—in particular diffusion weighted magnetic resonance imaging (dw-MRI)—have modified this view.

    In a recent study,2 scattered lesions in one vascular territory or multiple lesions in multiple vascular territories were actually more common than single …

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