ARTERIAL LESIONS UNDERLYING LACUNES

The arterial lesions causing lacunes have been investigated using serial sections of blocks of the basal ganglia and pons from four cases with a history of hypertension and small strokes. In 45 of 50 consecutive lacunes there was a total occlusion of the artery supplying the territory of the infarct. The associated vascular lesions were as follows: segmental arterial disorganization 40 (with enlargement 31, with hemorrhage 26, with fibrinoid deposit 14), thrombosis of a fusiform asymmetric microaneurysm, 2; plaque of foam cells (atherosclerosis) 3; complete absence of any lesion 1; suspected segmental disorganization 3; and miscellaneous 1. Segmental arterial disorganization has been discussed in some detail. Others have termed this condition hyalinosis, angionecrosis with aneurysm formation, plasmatic destruction, fibrinoid necrosis, fibrinoid arteritis, etc. © 1969 Springer-Verlag.