Vascular ataxic hemiparesis: a re-evaluation.

Détails

ID Serval
serval:BIB_45F171A7D82E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Vascular ataxic hemiparesis: a re-evaluation.
Périodique
Journal of Neurology, Neurosurgery, and Psychiatry
Auteur(s)
Moulin T., Bogousslavsky J., Chopard J.L., Ghika J., Crépin-Leblond T., Martin V., Maeder P.
ISSN
0022-3050 (Print)
ISSN-L
0022-3050
Statut éditorial
Publié
Date de publication
1995
Peer-reviewed
Oui
Volume
58
Numéro
4
Pages
422-427
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Ataxic hemiparesis is commonly considered as one of the "typical" lacunar syndromes. Using the prospective stroke registries from Lausanne and Besançon, 100 patients were selected consecutively (73% men, 27% women; age 64.7 (SD 13.6) years) with a first stroke and ataxic hemiparesis (hemiparesis or pyramidal signs and ipsilateral incoordination without sensory loss). Brain CT or MRI was performed on all patients. A primary haemorrhage was present in 5%, an infarct in 72%, isolated leukoaraiosis in 9%, and no apparent abnormality in 14%. The locations of lesions were the internal capsule (39%), pons (19%), thalamus (13%), corona radiata (13%), lentiform nucleus (8%), cerebellum (superior cerebellar artery territory) (4%), and frontal cortex (anterior cerebral artery territory) (4%). The clinical features of ataxic hemiparesis with different locations were almost identical. Only minor associated signs allowed the localisation of the lesions (paraesthesiae with a lesion in the thalamus; nystagmus or dysarthria with a cerebellar or pontine location). Crural paresis with homolateral ataxia was seen only with cortical paramedian frontal lesions. Presumed hypertensive small artery disease was not always found, but was still the leading cause of stroke, being present in 59% of the patients and in 62% of those with small deep infarcts. A potential source of embolism (arterial or cardiac) was found in one fourth of the patients. Therefore no definite association can be made between ataxic hemiparesis and lacunar infarction. In particular, so called uncommon lesion locations may not be rare. After extensive investigations a diagnosis of lacunar infarct can be retained in only slightly more than half of the cases.
Mots-clé
Adult, Aged, Aged, 80 and over, Analysis of Variance, Ataxia/etiology, Cerebrovascular Disorders/complications, Female, Hemiplegia/etiology, Humans, Male, Middle Aged, Prospective Studies, Risk Factors
Pubmed
Web of science
Open Access
Oui
Création de la notice
11/04/2008 9:23
Dernière modification de la notice
08/05/2019 17:55
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