What Is a Lacune? Dogged déjà vu doggerel

To the Editor:“Then you should say what you mean,” the March Hare went on.“I do,” Alice hastily replied; “at least–at least I mean what I say–that’s the same thing, you know.”“Not the same thing a bit!” said the Hatter.“Why, you might just as well say that ‘I see what I eat’ is the same thing as ‘I eat what I see’!”Alice in Wonderland—Lewis CarrollDr Wardlaw’s plaintive query1 documents 21st century survival of clinical science confusion driven by hopelessly specious terminology: “lacune,” “lacunar infarct,” “lacunar stroke,” “clinical stroke syndrome with typical symptoms and signs referable to a small subcortical or brain stem lesion,” “clinically evident lacunar infarct,” “clinical stroke syndrome of lacunar type where the underlying lesion is an infarct on brain-imaging,” “3 to 15 mm cerebrospinal fluid (CSF)-filled cavities in the basal ganglia or white matter, frequently observed coincidentally …