腔隙性脑梗死的历史、现状及展望

The history,current situation and prospect of lacunar infarct

现代腔隙性脑梗死(LI)的概念始于20世纪50至70年代,Fisher通过一系列细致的病理研究提出了“腔隙假说”。随着头颅CT/MRI影像技术及缺血性卒中病因分型的临床应用,LI又兼具影像和病因分型意义。因此,LI从最初病理学的诊断,到现在具有临床、影像、病因的多重身份,概念及内涵大大超出了最初的病理学含义,造成了目前名词的混乱和临床不同场合的滥用。文中将从LI的历史病理概念出发,系统综述LI的相关术语及概念演变过程,并对LI的未来研究方向及定义提出展望,以期为LI的规范化使用及研究提供参考。

The modern concept of lacunar infarct is largely based on the meticulous postmortem work of Fisher from the 1950s to 1970s,which forms the basis of the"lacunar hypothesis".Along with the application of CT or MRI techniques and classification of ischemic stroke subtypes,the lacunar infarct was endowed with the profile of imaging diagnosis and stroke subtypes.Thus,the concept of lacunar infarct has far expanded the initial pathological meanings and the terminology and definitions for lacunar infarct vary widely.In this review,the historical pathological findings and the term evolution of lacunar infarct were systemically reviewed,with a focus toward future directions in the complex entity of lacunar infarct.