[Lacunar infarct and deep cerebral hemorrhage: a comparison of the risk factors].
BACKGROUND
Lacunar infarcts (LI) and deep cerebral hemorrhages (DCH) have the same localization and a vasculopathy which appears to be similar, at the level of the small perforating arteries, classically attributed to arterial hypertension (AHT).


OBJECTIVE
To compare the vascular risk factors of patients with lacunar ictus (LIc) and those with DCH, to try to determine how these may affect the appearance of one type of stroke or another.


METHODS
We analyzed a prospective consecutive series of patients with cerebral vascular accidents (CVA), selecting 1,540 patients in the first 1,155 with a first CVA. We recorded demographic data and the following risk factors: previous transient ischemic accident (TIA), AHT, diabetes mellitus (DM), hypercholesterolemia, ischemic cardiopathy, atrial fibrillation and the presence of silent infarcts on CT.


RESULTS
Two hundred and four patients had LIc and 163 had DCH. There was a significant dissociation between LIc and a history of TIA, DM, hypercholesterolemia and the presence of silent lacunar-type infarcts on CT. However, after multivariant analysis, DM did not continue to be an independent variable. Arterial blood pressure was found to be greater in the DCH group.


CONCLUSIONS
The presence of different risk factors for LIc and DCH may be the key to understanding the mechanism which leads to one type or other of CVA.
Beltrán
I
I
Servicio de Neurología, Hospital Universitario La Fe, Valencia.
Lago
A
A
Tembl
J I
JI
Landete
L
L
Geffner
D
D
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000453:epidemiology; D002544:Cerebral Infarction / Q000150:complications* / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000150:complications; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D002546:Ischemic Attack, Transient / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology