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Arch Neurol. 2001;58:551-552.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

THE CLINICAL study of Cupini et al¹ in this issue of the ARCHIVES addresses a long-standing and vexing question, namely, what is the relationship between arteriolar hemodynamics and subcortical stroke? At the center of this question is the controversial lacuna, a 3- to 15-mm lesion first described by DeChambre in 1838.² It is found in characteristic locations in deep subcortical white matter tracts subserved by noncollateralizing penetrating arterioles arising from proximal cerebral arteries. It was C. Miller Fisher who advanced the lacunar concept with descriptions of pathologic features in these arterioles and associated clinical syndromes.² With smaller lacunae he described a distal subintimal arteriolar degeneration termed "lipohyalinosis"; these lesions were likely to be symptomatic only if strategically located in a sensory or motor tract. Larger lacunae, however, were associated with proximal occlusion or stenosis of the arteriole by "a tiny bead" of microatheroma. These larger lacunae were more likely to . . . [Full Text of this Article]

RELATED ARTICLE

Cerebrovascular Reactivity and Subcortical Infarctions
Letizia M. Cupini, Marina Diomedi, Fabio Placidi, Mauro Silvestrini, and Patrizia Giacomini
Arch Neurol. 2001;58(4):577-581.
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