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Just 42 patients in the recombinant tissue plasminogen activator trials were over 80, and only a few had lacunar strokes.
Careful consideration of the clinical history, as well as the presence of lacunar Reed-Sternberg cells in nodules surrounded by dense collagenous fibrosis, should suggest the diagnosis.
Patients with diabetes are probably more prone to irreversible rather than reversible ischaemic brain damage, and small lacunar infarcts are common.
In subgroup analysis, a possible beneficial effect was detected in patients with ischemic lacunar strokes.
Of the patients with AD, 15.5% also had cerebral microinfarcts, 19.4% had lacunar infarcts, and 19.4% had hippocampal sclerosis.
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