Ay et al listed criteria for the diagnosis of ischemic stroke caused by small vessel occlusion The authors are from Massachusetts General Hospital, Harvard Medical School, UCLA Medical Center, Columbia University and NINDS (of NIH).
Parameters:
(1) imaging studies
(2) history of stereotypic lacunar transient ischemic attacks (TIA) during week before
(3) classical lacunar syndrome
(4) exclusion of other causes affecting the parent artery (vasculitis, dissection, vasospasm, atheroma)
Imaging
History Lacunar TIA
Lacunar Syndrome
Other Causes
Diagnosis
classic appearance
NA
NA
excluded
evident
not done
present
present
NA
probable
not sensitive enough to detect
NA
present
not completely excluded
possible
where:
• Classic appearance of a small artery occlusion on imaging studies is a single infarct < 20 mm in maximum dimension withtin the territory of brainstem or basal penetrating arteries.
• Small artery occlusion is presumed excluded if an imaging study sensitive enough to detect one is negative.
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