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Supplementary Figure 1. A range of appearances (shape, location, presence/absence of other SVD) of acute small deep (lacunar) infarcts on diffusion weighted (DWI) and FLAIR MR imaging. A, small, ovoid, posterior limb of internal capsule, no other SVD features. B, small round centrum semiovale, many WMH. C, larger, ovoid, posterior limb internal capsule, other lacunes visible. D, tubular, external capsule to centrum semiovale, few other SVD lesions. We found no differences in a range of vascular risk factors, demographic or stroke features between patients with these different patterns of lesion, ADDIN REFMGR.CITE <Refman><Cite><Author>Del Bene</Author><Year>2012</Year><RecNum>20121</RecNum><IDText>Do risk factors for lacunar ischaemic stroke vary with the location or appearance of the lacunar infarct?</IDText><MDL Ref_Type="Journal"><Ref_Type>Journal</Ref_Type><Ref_ID>20121</Ref_ID><Title_Primary>Do risk factors for lacunar ischaemic stroke vary with the location or appearance of the lacunar infarct?</Title_Primary><Authors_Primary>Del Bene,A.</Authors_Primary><Authors_Primary>Makin,S.D.J.</Authors_Primary><Authors_Primary>Doubal,F.N.</Authors_Primary><Authors_Primary>Wardlaw,J.M.</Authors_Primary><Date_Primary>2012</Date_Primary><Keywords>etiology</Keywords><Keywords>of</Keywords><Keywords>stroke</Keywords><Keywords>and</Keywords><Keywords>Risk</Keywords><Keywords>Risk Factors</Keywords><Keywords>RISK-FACTORS</Keywords><Reprint>Not in File</Reprint><Start_Page>21</Start_Page><Periodical>Cerebrovasc Dis</Periodical><Volume>33</Volume><Issue>Suppl 1</Issue><ZZ_JournalStdAbbrev><f name="System">Cerebrovasc Dis</f></ZZ_JournalStdAbbrev><ZZ_WorkformID>1</ZZ_WorkformID></MDL></Cite></Refman>1 the only differences being a marginally more severe stroke (NIHSS 2.5 vs 2) and more frequent embolic source (13 vs 4%) with basal ganglia vs centrum semiovale lesions .BACDSupplementary Figure 2. Striatocapsular infarct. ADDIN REFMGR.CITE <Refman><Cite><Author>Donnan</Author><Year>1991</Year><RecNum>9378</RecNum><IDText>The stroke syndrome of striatocapsular infarction</IDText><MDL Ref_Type="Journal"><Ref_Type>Journal</Ref_Type><Ref_ID>9378</Ref_ID><Title_Primary>The stroke syndrome of striatocapsular infarction</Title_Primary><Authors_Primary>Donnan,G.A.</Authors_Primary><Authors_Primary>Bladin,P.F.</Authors_Primary><Authors_Primary>Berkovic,S.F.</Authors_Primary><Authors_Primary>Longley,W.A.</Authors_Primary><Authors_Primary>Saling,M.M.</Authors_Primary><Date_Primary>1991/2</Date_Primary><Keywords>abnormalities</Keywords><Keywords>Acute</Keywords><Keywords>angiography</Keywords><Keywords>Arteries</Keywords><Keywords>Artery</Keywords><Keywords>Article</Keywords><Keywords>Australia</Keywords><Keywords>Carotid Arteries</Keywords><Keywords>Carotid Artery</Keywords><Keywords>Cerebral Angiography</Keywords><Keywords>Cerebral Arteries</Keywords><Keywords>Cerebral Infarction</Keywords><Keywords>Cerebrovascular Disorders</Keywords><Keywords>Corpus Striatum</Keywords><Keywords>Disease</Keywords><Keywords>Embolism</Keywords><Keywords>Female</Keywords><Keywords>Hospital</Keywords><Keywords>Humans</Keywords><Keywords>Infarction</Keywords><Keywords>ischaemic stroke</Keywords><Keywords>Male</Keywords><Keywords>Middle Aged</Keywords><Keywords>Middle Cerebral Artery</Keywords><Keywords>Neurology</Keywords><Keywords>Neuropsychological Tests</Keywords><Keywords>Occlusion</Keywords><Keywords>outcome</Keywords><Keywords>Patient</Keywords><Keywords>Patients</Keywords><Keywords>physiopathology</Keywords><Keywords>presentation</Keywords><Keywords>Prognosis</Keywords><Keywords>Prospective Studies</Keywords><Keywords>Prospective Study</Keywords><Keywords>radiography</Keywords><Keywords>Risk</Keywords><Keywords>Risk Factors</Keywords><Keywords>Smoking</Keywords><Keywords>Spectrum</Keywords><Keywords>stroke</Keywords><Keywords>Study</Keywords><Keywords>Syndrome</Keywords><Keywords>Tomography,X-Ray Computed</Keywords><Reprint>Not in File</Reprint><Start_Page>51</Start_Page><End_Page>70</End_Page><Periodical>Brain</Periodical><Volume>114</Volume><Issue>Pt 1A</Issue><Address>Department of Neurology, Austin Hospital, Melbourne, Australia</Address><Web_URL>PM:1998890</Web_URL><ZZ_JournalFull><f name="System">Brain</f></ZZ_JournalFull><ZZ_WorkformID>1</ZZ_WorkformID></MDL></Cite></Refman>2 Top: Acute DWI (left) and FLAIR (middle, right) images on day of stroke shows large subcortical acute infarct in the basal ganglia and centrum semiovale, much too large to be considered as lacunar. Bottom: FLAIR images several months later show a small lacune where the original large lesion was, less than 2cm diameter, showing that acute lesions can evolve rapidly and how easy it would be to associate large artery atherothromboembolic mechanisms with lacunar stroke. The clue to the original diagnosis is the ex-vacuo effect (enlargement) of the left lateral ventricle to take up space left following tissue destruction by the original large infarct.FLAIRDWIFLAIRBSupplementary Figure 3. Late appearances of lacunar lesions in three different patients. A) A lacunar lesion showing cavitation (H&E x40). A cystic cavity has formed around a central small vessel, and there is surrounding reactive gliosis. B) There is tissue damage with reactive gliosis and white matter rarefaction, but no cystic degeneration (H&E x40). The patient had no symptoms in life. C) Higher magnification of an evolving cystic lesion in the putamen, with foamy macrophage infiltration and tissue destruction. The patient was a 42 year old with extensive pathological SVD (arteriolosclerosis and lipohyalinosis), but with no neurological symptoms during life or known vascular risk factors. The histological changes suggest that the lesion is at least 2-3 weeks old, and was not associated with the cause of death. Note the inflammatory cell vessel wall infiltrate. (H&E x100). ACBBCAC ADDIN REFMGR.REFLIST Reference List1Del Bene A, Makin SDJ, Doubal FN, Wardlaw JM. Do risk factors for lacunar ischaemic stroke vary with the location or appearance of the lacunar infarct? Cerebrovasc Dis 2012;33:21.2Donnan GA, Bladin PF, Berkovic SF, Longley WA, Saling MM. The stroke syndrome of striatocapsular infarction. Brain 1991;114:51-70. ................
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