A special form of cerebral lacunae: expanding lacunae

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 61; no. 2; pp. 200 - 202
• Main Authors: Homeyer, P, Cornu, P, Lacomblez, L, Chiras, J, Derouesné, C
• Format: Journal Article Conference Proceeding
• Language: English
• Published: London BMJ Publishing Group Ltd 01.08.1996; BMJ; BMJ Publishing Group LTD
• Subjects: Adult; Biological and medical sciences; Calcinosis - pathology; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Humans; Hydrocephalus - diagnosis; Hydrocephalus - physiopathology; Hydrocephalus - surgery; Magnetic Resonance Imaging; Male; Medical sciences; Mesencephalon - physiopathology; Mesencephalon - surgery; Nervous system (semeiology, syndromes); Neurology; Thalamus - pathology; Thalamus - physiopathology; Thalamus - surgery; Human; Cerebral infarction; Nervous system diseases; Central nervous system; Cerebral lacuna; Cardiovascular disease; Exploration; Male; Nuclear magnetic resonance imaging; Cerebral disorder; Vascular disease; Case study; Central nervous system disease; Hydrocephaly; Cerebrovascular disease; Brain (vertebrata)
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.61.2.200

The case of a 42 year old man with headache, blurred vision, and diplopia allowed the description of a particular form of cerebral lacunae-that is, expanding lacunae. Brain MRI showed hydrocephalus and multiple lesions in the thalamomesencephalic region. The radiological features of these lesions were similar to the histological brain coronal section of a case reported in 1983 in which expanding lacunae were related to a dilatation of the perivascular spaces and a focal segmental necrotising angiitis. The role of the lymphatic drainage of the brain is discussed to explain the dilatation of the perivascular spaces. The hypothesis of a hydrodynamic factor being responsible for the expanding character of the lacunae was suggested by the location of the lesions and the influence of various clinical events on the symptomatology.