Lacunar Infarct and Asymmetric WMH - Oren Zarif - Lacunar Infarct

Lacunar infarct is a condition in which the blood flow to a part of the brain is interrupted or is obstructed. The infarct is small in size and appears as ill-defined hypodensity. It is caused by an embolism, thrombosis, or an in situ microatheroma, and it does not typically affect higher cortical functions.

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In the study, abnormalities in the CTP were associated with the presence of an infarct. However, these findings did not correlate with the focus of restricted diffusion on DWI. Therefore, the abnormalities on CTP appeared as regional lesions that were larger than the lacunar infract. In a previous study, Rudilosso et al. (15) reported that lacunar infracts were associated with abnormalities on CTP, but they did not specify the threshold. In addition, the present study did not include patients who had coexisting infarcts or a lacunar infract larger than 2 cm in size.

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The cerebrovascular system consists of the cerebral artery, which is largely composed of arteries. The main branches of the cerebral artery are the anterior, middle, and posterior cerebral arteries. The basilar, vertebral, and middle cerebral arteries feed the deep gray and white matter. Small infarcts are caused by occlusion of smaller penetrating arteries. Lacunar infarcts vary in size, with approximately one-sixth of them being less than 10 mm in size.

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The acute lacunar infarcts that are associated with asymmetric WMH may be more vulnerable to this type of stroke. Furthermore, asymmetric WMH is more susceptible to lacunar infracts, and those with a large WMH burden may be at a greater risk for subsequent lacunar stroke. However, the study also highlights the necessity for more research in the area to identify the specific patterns of lacunar infarcts and the potential benefits they can offer.

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The most common clinical symptom of lacunar infract is hypodensity on CT. The presence of cerebrospinal fluid is indicative of gliosis. Patients may also experience lightheadedness, hiccups, or asterixis. Clinical outcome of lacunar infract is often poor. Symptomatic treatment should be aimed at reducing the risk of complications. Infarcts in this region may be difficult to distinguish because they are small in size.

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Treatment of lacunar infract is similar to that of ischemic stroke. Antiplatelet therapy can break up blood clots and thereby reduce stroke risk. Patients may also undergo thrombectomy to remove blood clots. Following the procedure, patients are typically prescribed blood-thinning drugs for 90 days. Once the blood clots have been removed, physiotherapy is often used to improve lost abilities.

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The symptoms of lacunar infract vary according to which part of the brain is affected. Because different regions control different parts of the body, it's important to identify which part of the brain has been affected. The right hemisphere is responsible for motor function and sensation in the left side, while the left hemisphere controls motor function in the right side. Thus, if a lesion occurs on one side of the brain, it may affect the opposite side of the body.

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A micro atheroma in the lenticulostriate branch is another cause of lacunar infarction. Other causes of small infarcts include embolism, vasculitis, and infections. Lacunar infarcts are not as well defined as ischemic strokes. It is important to recognize the signs and symptoms of lacunar infarcts and distinguish it from other causes of ischemic stroke.

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A new study suggests that CTP may be superior to NCCT/CTA in detecting lacunar infarcts. The study examined 1085 CTP examinations in patients with acute stroke symptoms and an MRI within seven days. The patients had an infarct of 2 cm or more and were scored according to NIHSS. There are some limitations to this study, though. It's important to keep in mind the importance of these studies.