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Aetiology

Authoring team

Lacunar strokes are most frequently due to poorly- controlled hypertension.

Perforating vessels may occlude due to lipohyalinosis, micro-atheroma or fibrin. These first 2 mechanisms are pathological and likely due to chronic hypertension resulting in small vessel disease. (1)

Lacunar strokes are rarely due to emboli from a proximal source e.g. extracranial atherosclerosis or cardiac emboli.

Reference

  1. Wardlaw JM, Smith C, Dichgans M. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol. 2013 May;12(5):483-97.

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