title: Transesophageal echocardiography findings in lacunar stroke.
abstract: BACKGROUND
  Transesophageal echocardiography (TEE) constitutes a valuable tool in patients with stroke and cardiac embolization, but its indication is controversial in lacunar stroke. The purpose of this study was to assess the findings of TEE in lacunar stroke.
  
  
  METHODS
  Initial symptoms, brain computed tomography or magnetic resonance imaging, and TEE were performed for all patients with ischemic stroke admitted consecutively to our department of neurology. The subtype of ischemic stroke (lacunar v large-vessel stroke) was also reviewed.
  
  
  RESULTS
  In all, 124 patients with ischemic stroke were identified and lacunar syndrome occurred in 46. Major risk factor of embolization in patients with lacunar stroke and indication for anticoagulation were detected in 20% (9 of 46). We compared findings in both groups (lacunar v nonlacunar stroke) to evaluate the differences in the presence of major risk factor for embolization, Chi square = 0.07, P = .8 (odds ratio 95% CI = 0.35-2.18). Characteristics of the 9 patients with lacunar stroke and major risk of embolization show that history of lacunar ischemic stroke was present in all the patients of this group.
  
  
  CONCLUSIONS
  The results of the study suggest that TEE may be necessary to obtain a complete evaluation to optimize preventive treatment in patients with clinical and radiologic presentation that suggest lacunar infarct, particularly in cases with a history of ischemic stroke, in which a potential cardiac source of embolization may be detected.
authors.affiliation: Neurology Department, Italian Hospital of Buenos Aires, Argentina. juan.rojas@hospitalitaliano.org.ar
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Rojas
authors.forename: María Cristina
authors.initials: MC
authors.lastname: Zurru
authors.forename: Marina
authors.initials: M
authors.lastname: Romano
authors.forename: Liliana
authors.initials: L
authors.lastname: Patrucco
authors.forename: Mariano
authors.initials: M
authors.lastname: Falconi
authors.forename: Edgardo
authors.initials: E
authors.lastname: Cristiano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D020520:Brain Infarction / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000925:Anticoagulants