| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Neurology (Dr. You, H.M. O'Malley, and Dr. Donnan), Austin and Heidelberg Hospitals, University of Melbourne; the Department of Social and Preventive Medicine (Dr. McNeil), Monash University; and the Department of Neurology (Dr. Davis), Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.
Supported by a grant from the Victorian Health Promotion Foundation and Australian Stroke and Neuroscience Institute, Australia. Dr. You was supported by a Postgraduate Research Scholarship of the Australian National Health and Medical Research Council.
Received September 20, 1994. Accepted in final form December 30, 1994.
Address correspondence and reprint requests to Prof Donnan, Department of Neurology, Austin and Heidelberg Hospitals, Heidelberg, VIC 3084, Australia.
Background and purpose: Lacunar infarction is an important stroke subgroup with unique clinical and pathologic features, but its relative risks for associated risk factors have been rarely documented. To address this matter, we studied 203 consecutive patients with first-ever stroke due to lacunar infarction admitted to four general hospitals during the period 1985 to 1992. Methods: We obtained information concerning risk factor exposure status among the patients by interview using a structured questionnaire and by comparison with age- and sex-matched neighborhood controls. Odds ratios were estimated with adjustment for confounding variables by using multivariate logistic regression. Results: Significantly increasing the risk of lacunar stroke were hypertension (with an odds ratio of 8.9 [95% confidence intervals 4.2, 18.8]), current smoking (6.6 [2.9, 14.8]), and diabetes (2.3 [1.0, 5.5]), whereas frequent physical exercise was associated with a significantly decreased risk (0.3 [0.1, 0.7]). There was no risk of lacunar stroke associated with heart disease (odds ratio 1.0 [0.5, 1.9]). Conclusions: Patients with hypertension or diabetes, and those who currently smoke, are at a higher risk of lacunar stroke, whereas those who undertake regular physical exercise may be at lower risk. The high risk associated with hypertension but absent risk with heart disease supports the ``lacunar hypothesis'' of a unique pathophysiologic mechanism for lacunar stroke.
NEUROLOGY 1995;45: 1483-1487
This article has been cited by other articles:
|
|
 |
|
  G. Jickling, A. Salam, A. Mohammad, M. S. Hussain, J. Scozzafava, A. M. Nasser, T. Jeerakathil, A. Shuaib, and R. Camicioli Circulating Endothelial Progenitor Cells and Age-Related White Matter Changes Stroke, October 1, 2009; 40(10): 3191 - 3196. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Bejot, A. Catteau, M. Caillier, O. Rouaud, J. Durier, C. Marie, A. Di Carlo, G.-V. Osseby, T. Moreau, and M. Giroud Trends in Incidence, Risk Factors, and Survival in Symptomatic Lacunar Stroke in Dijon, France, From 1989 to 2006: A Population-Based Study Stroke, July 1, 2008; 39(7): 1945 - 1951. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Sacco, C. Marini, R. Totaro, T. Russo, D. Cerone, and A. Carolei A population-based study of the incidence and prognosis of lacunar stroke Neurology, May 9, 2006; 66(9): 1335 - 1338. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Seifert, C Enzinger, M K Storch, G Pichler, K Niederkorn, and F Fazekas Acute small subcortical infarctions on diffusion weighted MRI: clinical presentation and aetiology J. Neurol. Neurosurg. Psychiatry, November 1, 2005; 76(11): 1520 - 1524. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Wendel-Vos, A. Schuit, E. Feskens, H. Boshuizen, W. Verschuren, W. Saris, and D Kromhout Physical activity and stroke. A meta-analysis of observational data Int. J. Epidemiol., August 1, 2004; 33(4): 787 - 798. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Arboix, Y Bell, L Garcia-Eroles, J Massons, E Comes, M Balcells, and C Targa Clinical study of 35 patients with dysarthria-clumsy hand syndrome J. Neurol. Neurosurg. Psychiatry, February 1, 2004; 75(2): 231 - 234. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. D. Lee, A. R. Folsom, and S. N. Blair Physical Activity and Stroke Risk: A Meta-Analysis Stroke, October 1, 2003; 34(10): 2475 - 2481. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Arauz, L. Murillo, C. Cantu, F. Barinagarrementeria, and J. Higuera Prospective Study of Single and Multiple Lacunar Infarcts Using Magnetic Resonance Imaging: Risk Factors, Recurrence, and Outcome in 175 Consecutive Cases Stroke, October 1, 2003; 34(10): 2453 - 2458. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U.G.R. Schulz and P.M. Rothwell Differences in Vascular Risk Factors Between Etiological Subtypes of Ischemic Stroke: Importance of Population-Based Studies Stroke, August 1, 2003; 34(8): 2050 - 2059. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Siritho, A. G. Thrift, J. J. McNeil, R. X. You, S. M. Davis, and G. A. Donnan Risk of Ischemic Stroke Among Users of the Oral Contraceptive Pill: The Melbourne Risk Factor Study (MERFS) Group Stroke, July 1, 2003; 34(7): 1575 - 1580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. W. Baumgartner, C. Sidler, M. Mosso, D. Georgiadis, and L. R. Caplan Ischemic Lacunar Stroke in Patients With and Without Potential Mechanism Other Than Small-Artery Disease * Editorial Comment Stroke, March 1, 2003; 34(3): 653 - 659. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. P. Gerraty, M. W. Parsons, P. A. Barber, D. G. Darby, P. M. Desmond, B. M. Tress, and S. M. Davis Examining the Lacunar Hypothesis With Diffusion and Perfusion Magnetic Resonance Imaging Stroke, August 1, 2002; 33(8): 2019 - 2024. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Kelly, B.J. Hunt, A. Rudd, and R.R. Lewis Should patients with lacunar stroke and severe carotid artery stenosis undergo endarterectomy? QJM, May 1, 2002; 95(5): 313 - 319. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Nasreen, T. Nabika, H. Shibata, H. Moriyama, K. Yamashita, J. Masuda, and S. Kobayashi T-786C Polymorphism in Endothelial NO Synthase Gene Affects Cerebral Circulation in Smokers: Possible Gene-Environmental Interaction Arterioscler Thromb Vasc Biol, April 1, 2002; 22(4): 605 - 610. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L.M. Cupini, P. Pasqualetti, M. Diomedi, F. Vernieri, M. Silvestrini, B. Rizzato, F. Ferrante, and G. Bernardi Carotid Artery Intima-Media Thickness and Lacunar Versus Nonlacunar Infarcts Stroke, March 1, 2002; 33(3): 689 - 694. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Yamamoto, I. Akiguchi, K. Oiwa, M. Hayashi, T. Kasai, and K. Ozasa Twenty-four-Hour Blood Pressure and MRI as Predictive Factors for Different Outcomes in Patients With Lacunar Infarct Stroke, January 1, 2002; 33(1): 297 - 305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Arboix, I Padilla, J Massons, L Garcia-Eroles, E Comes, and C Targa Clinical study of 222 patients with pure motor stroke J. Neurol. Neurosurg. Psychiatry, August 1, 2001; 71(2): 239 - 242. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Tanizaki, Y. Kiyohara, I. Kato, H. Iwamoto, K. Nakayama, N. Shinohara, H. Arima, K. Tanaka, S. Ibayashi, and M. Fujishima Incidence and Risk Factors for Subtypes of Cerebral Infarction in a General Population : The Hisayama Study Stroke, November 1, 2000; 31(11): 2616 - 2622. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kazui, C. R. Levi, E. F. Jones, L. Quang, P. Calafiore, and G. A. Donnan Risk factors for lacunar stroke: A case-control transesophageal echocardiographic study Neurology, March 28, 2000; 54(6): 1385 - 1387. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Inzitari, M. Eliasziw, B. L. Sharpe, A. J. Fox, and H. J. M. Barnett Risk factors and outcome of patients with carotid artery stenosis presenting with lacunar stroke Neurology, February 8, 2000; 54(3): 660 - 660. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Notsu, T. Nabika, H.-Y. Park, J. Masuda, and S. Kobayashi Evaluation of Genetic Risk Factors for Silent Brain Infarction Stroke, September 1, 1999; 30(9): 1881 - 1886. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. R. Evenson, W. D. Rosamond, J. Cai, J. F. Toole, R. G. Hutchinson, E. Shahar, and A. R. Folsom Physical Activity and Ischemic Stroke Risk : The Atherosclerosis Risk in Communities Study Stroke, July 1, 1999; 30(7): 1333 - 1339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Nakamura, Y. Saku, S. Ibayashi, and M. Fujishima Progressive motor deficits in lacunar infarction Neurology, January 1, 1999; 52(1): 29 - 29. [Abstract] [Full Text]
|
|
|
|
 |
|
 W. T. Longstreth Jr, C. Bernick, T. A. Manolio, N. Bryan, C. A. Jungreis, T. R. Price, and for the Cardiovascular Health Study Collaborative Lacunar Infarcts Defined by Magnetic Resonance Imaging of 3660 Elderly People: The Cardiovascular Health Study Arch Neurol, September 1, 1998; 55(9): 1217 - 1225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. R. Davis, T. Vogt, P. H. Frost, A. Burlando, J. Cohen, A. Wilson, L. M. Brass, W. Frishman, T. Price, and J. Stamler Risk Factors for Stroke and Type of Stroke in Persons With Isolated Systolic Hypertension Stroke, July 1, 1998; 29(7): 1333 - 1340. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. G. Thrift, J. J. McNeil, A. Forbes, and G. A. Donnan Three Important Subgroups of Hypertensive Persons at Greater Risk of Intracerebral Hemorrhage Hypertension, June 1, 1998; 31(6): 1223 - 1229. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Lammie, F. Brannan, J. Slattery, and C. Warlow Nonhypertensive Cerebral Small-Vessel Disease : An Autopsy Study Stroke, November 1, 1997; 28(11): 2222 - 2229. [Abstract] [Full Text]
|
|
|
|
|
|
R. X. You, J. J. McNeil, H. M. O'Malley, S. M. Davis, A. G. Thrift, and G. A. Donnan Risk Factors for Stroke Due to Cerebral Infarction in Young Adults Stroke, October 1, 1997; 28(10): 1913 - 1918. [Abstract] [Full Text]
|
|
|
|
|
|
S. Kobayashi, K. Okada, H. Koide, H. Bokura, and S. Yamaguchi Subcortical Silent Brain Infarction as a Risk Factor for Clinical Stroke Stroke, October 1, 1997; 28(10): 1932 - 1939. [Abstract] [Full Text]
|
|
|
|
|
|
A. G. Thrift, J. J. McNeil, A. Forbes, and G. A. Donnan Risk Factors for Cerebral Hemorrhage in the Era of Well-Controlled Hypertension Stroke, November 1, 1996; 27(11): 2020 - 2025. [Abstract] [Full Text]
|
|
|
|
|
|
N. Watanabe, Y. Imai, K. Nagai, I. Tsuji, H. Satoh, M. Sakuma, H. Sakuma, J. Kato, N. Onodera-Kikuchi, M. Yamada, et al. Nocturnal Blood Pressure and Silent Cerebrovascular Lesions in Elderly Japanese Stroke, August 1, 1996; 27(8): 1319 - 1327. [Abstract] [Full Text]
|
|
|
|
|
|
S. Nasreen, T. Nabika, H. Shibata, H. Moriyama, K. Yamashita, J. Masuda, and S. Kobayashi T-786C Polymorphism in Endothelial NO Synthase Gene Affects Cerebral Circulation in Smokers: Possible Gene-Environmental Interaction Arterioscler Thromb Vasc Biol, April 1, 2002; 22(4): 605 - 610. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
