A total of 74 CT scans from patients with lacunar syndromes were presented to 10 raters, most of them experienced in neuroradiology. The attributes to be judged were: lacunar infarcts (yes/no), leuko-araiosis (decreased density of the cerebral white matter) (yes/no), cortical atrophy (yes/no), and normal (yes/no). The chance corrected kappa coefficients were 0.641 for decreased density, 0.445 for lacunar infarcts and 0.206 for cortical atrophy. Taking into consideration the attribute cortical atrophy, the kappa coefficient for the attribute normal was 0.330, and without taking cortical atrophy into consideration, it was 0.523. Studies of lacunar infarcts and of leuko-araiosis should be based on clear definitions in order to guarantee a minimum level of interrater agreement.