Lacunar Infarct Causes and Risk Factors - Oren Zarif - Lacunar
Lacunar infarcts are rare, and they are most common in a single location on an MRI. These infarcts can be difficult to diagnose. Luckily, there are ways to help reduce the risk of developing lacunar strokes. In this article, we'll examine the causes and treatment options for lacunar stroke. We'll also examine some common risk factors. Here are a few of them.
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The concept of the lacunar infarction dates to the late nineteenth and early twentieth centuries, although imaging technology has confirmed the initial hypothesis in the 21st century. While the term is typically associated with a small chronic cavity that is part of a lacunar infarction, it can also be a result of a larger infarction or intracerebral hemorrhage. In the present study, lacunar infarction was the most common cause of stroke, but it was not the only cause.
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A lacunar stroke can occur when a small artery deep within the brain becomes blocked. The artery that supplies these deep areas of the brain is small and branches directly off of the larger main artery. This large artery is heavily muscled and carries high blood pressure. High blood pressure can cause a lacunar infarction. It also directly damages arteries, which in turn cause atherosclerosis, or fatty deposits on the walls of blood vessels.
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A comprehensive neurological examination will reveal any potential damage to brain functions. A heart function test may also be necessary. Early treatment increases a patient's chance of survival and may prevent further damage. Aspirin, blood pressure medication, and medications to reduce stroke risk are often prescribed. MRI scans may also help identify lacunar strokes. MRI-defined lacunes are more accurate than CT-imaging. Further studies are needed to determine the role of lacunes as risk factors for subsequent stroke.
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A recent study has revealed that nearly one-third of all ischaemic strokes are lacunar in origin. Its pathophysiology and treatment are still poorly understood. A small portion of lacunar strokes result from emboli from artery to artery. The rest are caused by intracranial large artery stenoses. The incidence of lacunar stroke is increasing in the United States. When a lacunar infarct is discovered, a treatment plan must be initiated immediately to decrease the risk of a stroke.
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A large number of individuals who have suffered a lacunar stroke do not show any clinical symptoms. Their symptoms can vary according to which part of the brain is deprived of blood. Different areas of the brain are responsible for different functions. They include those responsible for movement, sensation, speech, and balance. People with prolonged high blood pressure can develop multiple lacunar infarcts. Multiple lacunar stroke may also lead to emotional behavior or dementia.
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Patients with a suspected lacunar stroke should undergo a CT/MRI to rule out other serious conditions. Because these areas of the brain have small perforating arteries, these images are difficult to interpret. The diagnosis of lacunar stroke is usually made by matching the symptoms to the area that has been damaged. There are five main types of lacunar stroke. The most common type is a pure motor stroke. The technical term is pure motor paresis, and hemiparesis refers to weakness of the affected side of the body.
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A patient with a large subcortical infarct may have a larger stroke. MRI imaging can help distinguish lacunar infarcts from large vessel infarcts. Patients with severe carotid stenosis have an increased risk of stroke, which is why carotid artery intervention is commonly recommended. If a patient has no other obvious medical conditions, a patient may need an extensive embolic workup.
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Treatment for lacunar stroke is important, but it needs to be fast. If the diagnosis is made within three hours of the first onset of symptoms, treatment can greatly reduce the symptoms of this type of stroke. Fortunately, recovery from lacunar stroke is generally higher than with other types of strokes. Ninety percent of patients will recover to a significant extent within three months. Even more severe stroke patients will need physical therapy. If left untreated, lacunar stroke may lead to permanent disability.
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Although some lacunes are caused by ischemic stroke, the prevalence of emboli is low in these cases. In 16.6% of cases, however, there is no evidence of ischemia. However, the presence of limb weakness, sudden onset, and a patient with atrial fibrillation may be signs of a broader stroke. Although it is still difficult to determine the cause, these cases are important to be investigated.
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