Blood flow velocities of cerebral arteries in lacunar infarction and other ischemic strokes

Blood flow velocity is an important determinant of vascular hemodynamics. The aim of the present study was to determine the mean flow velocities (MFVs) of cerebral arteries in patients with ischemic stroke, comparing lacunar and nonlacunar infarctions. 388 consecutive patients were examined for lacunar infarction, other subtypes of ischemic stroke, and the presence of underlying internal carotid artery steno-occlusion (ICS). MFVs were measured using transcranial Doppler along the full segments of each cerebral artery including both right and left middle cerebral arteries, basilar artery, and both of the vertebral arteries. The patients were categorized into two major groups: lacunar infarction, and nonlacunar infarction with or without underlying ICS. The characteristics of patients with lacunar infarction (n=83, 21.4%) were significantly different from those with nonlacunar infarctions: younger age, lower prevalence of type 2 diabetes, and lower concentration of plasma total homocysteine. The patients with lacunar infarction had lower MFVs in cerebral arteries than the patients with nonlacunar infarctions, especially in the posterior circulation vessels such as the basilar artery and both vertebral arteries. Different hemodynamics might be pathophysiologically associated with the lacunar infarction, compared with the other subtypes of ischemic stroke.