Smallvessel Occlusion

Small-vessel occlusions, i.e., thrombosis of a single perforating cerebral artery, cause lacunar ischemic strokes. A lacunar infarct usually occurs in the internal capsule or thalamus and presents clinically as a pure motor stroke, pure sensory stroke, sensomotor stroke, dysarthria clumsy hand or ataxic hemiparesis. Patients with typical lacunar infarct syndromes account for approximately 20% of all ischemic strokes, and hypertensive small-vessel disease seems to be the most important etiology [29], Because heavy drinking of alcohol is a frequent cause of arterial hypertension, it is assumed to associate with small-vessel occlusion as well. However, conflicting observations have also been reported. Some studies have not shown alcohol to be a significant risk factor [29-31], whereas others have [9,32], The study ofYou et al. included a rather large series of young adults with lacunar infarcts [33]. This study suggested that long-term heavy alcohol consumption is a risk factor for ischemic brain infarct, whereas recent heavy drinking is not. The following case history suggests a relationship between alcohol drinking and the onset of lacunar brain infarct.

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