CTP Detects Lacunar Infarcts - Oren Zarif - Lacunar Infarct
In patients with multiple lacunar infarcts, the findings on CTP may be indicative of the cumulative effect of these strokes. Because of their small size, lacunar strokes may not be readily apparent on CT imaging. Therefore, extensive angiographic testing may be necessary to diagnose the underlying cause of the stroke. This type of procedure can detect blood vessel blockages but may not be necessary in patients with a single lacunar infract.
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Patients with an arteriole or a subcortical artery can also develop a lacunar stroke. It is usually a fast-recovery infarction owing to its characteristic clinical presentation. However, it is important to exclude other potential sources of intracranial strokes before confirming a diagnosis of lacunar infract. This way, patients are likely to recover. However, white matter damage may occur in the patient and may result in subcortical dementia.
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Lacunar infracts are strongly related to cortical infarcts. The underlying cause of lacunar infarcts is unclear, but studies have found that they are closely associated with stroke in the basal ganglia and deep white matter. Patients with a history of cerebrovascular disease were more likely to develop a lacunar infarct than those without. In addition, the size of the infarct may influence the risk of developing the infarct.
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CTP has been found to be superior to NCCT/CTA in detecting lacunar infarcts. Researchers evaluated the sensitivity and specificity of CTP by analyzing 1085 cases from patients with acute stroke symptoms and subsequent MRIs within 7 days. Infarcts of 2 cm or more were identified and recorded. The study was carried out using the NIHSS score for the patients.
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In the present study, a trained investigator searched the whole brain to detect silent lacunar infarcts. Infarcts must be hypointense on T2-weighted images and be contained within a WMH. Further, these findings were differentiated from perivascular spaces, which are dilated and do not exhibit the characteristic features of an infarct. This study is currently ongoing.
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After identifying the underlying cause, doctors may perform a comprehensive neurological examination. They may also administer intravenous medications to break up the clot. A neurosurgeon may remove the blockage or clot in the brain using a surgical procedure. Although lacunar stroke is not life-threatening, it can leave some brain damage that may impair the patient's ability to care for themselves. In general, recovery depends on the severity of the stroke.
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The symptoms of a lacunar infract are dependent on the region of the brain infected. Each part of the brain controls different aspects of the body. The right hemisphere controls motor function and sensation on the left side of the body, while the left hemisphere controls sensation on the right side of the body. As a result, a lesion in one region of the brain may cause symptoms on the opposite side of the body.