Diffusion-weighted MRI findings in patients with capsular warning syndrome

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Staaf, GertLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine (author)

Diffusion-weighted MRI findings in patients with capsular warning syndrome

Article/chapterEnglish2004

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2003-12-22
S. Karger AG,2004

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LIBRIS-ID:oai:lup.lub.lu.se:e42daf77-8aca-469d-93c4-a0d0358b3ee0
https://lup.lub.lu.se/record/292484URI
https://doi.org/10.1159/000073891DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype

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Background and Purpose: The 'capsular warning syndrome' (CWS) of recurrent stereotyped episodes of motor or sensory dysfunction is clinically well recognized, and is associated with a high risk of imminent lacunar infarction with permanent deficits resembling those of CWS. However, the pathophysiology of CWS has not been well characterized. We report a clinicoanatomic correlation with MR imaging studies in the acute and chronic phases in patients with CWS. Material and Methods: Between April 1997 and March 2001, we prospectively studied 8 patients, mean age 73.3 years, presenting with 4 - 17 motor or sensorimotor transient ischemic attacks ( TIAs; duration 2 - 90 min) up to 3 days after onset of the first episode. Four patients were free of symptoms between the attacks and had no residua, whereas 4 patients developed a pure motor or sensorimotor stroke within 1 - 3 days after symptom onset. Diffusion-weighted echoplanar MRI (DWI) and T-2-weighted MRI studies were performed within 1 week after symptom onset and were repeated 1 - 2 months later. Results: Seven of the 8 patients had an appropriate lesion on DWI in the acute phase. DWI abnormalities in the 3 patients with TIAs were 4 - 10 mm in diameter and confined to the lateral thalamus or medial globus pallidus without involving the internal capsule, whereas 4 patients who developed a stroke had abnormalities localized to the putamen extending to corona radiata ( 3 patients), or the pontomesencephalic junction ( 1 patient). All 6 patients who underwent follow-up MRI had an infarct on T-2-weighted images corresponding to, but usually smaller than, the acute phase DWI abnormality. Conclusions: Small infarcts in the basal ganglia or the pons, close to central motor pathways, appear to be the primary lesion in CWS. The pathophysiology of CWS is complex, and may involve hemodynamic mechanisms in penetrating arterial territories, as well as molecular mechanisms, such as peri-infarct depolarizations affecting adjacent motor pathways. Copyright (C) 2004 S. Karger AG, Basel.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
imaging
magnetic resonance
stroke
cerebral infarction
lacunar infarction

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Geijer, BoLund University,Lunds universitet,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)drad-bge (author)
Lindgren, ArneLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)neur-ali (author)
Norrving, BoLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)neur-bno (author)
Neurologi, LundSektion IV (creator_code:org_t)

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In:Cerebrovascular Diseases: S. Karger AG17:1, s. 1-81421-97861015-9770

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By the author/editor: Staaf, Gert; Geijer, Bo; Lindgren, Arne; Norrving, Bo

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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