Early Clinical Diagnosis of Lacunar Strokes

To the Editor:Phillips and colleagues1 report the GAIN Americas data to describe the relationships between the OCSP2 and TOAST3 classifications tools, focusing on the accuracy of the OCSP classification in the early diagnosis of a lacunar stroke.The authors classify lacunar syndromes (LS) within 6 hours of stroke onset and conclude that the OCSP classification is highly accurate in detecting a lacunar stroke. As reference standard they used the diagnosis of small-vessel disease according to the TOAST classification performed at 7 days after stroke onset or at hospital discharge, after a battery of investigations which was not …