Lacunar Infarct in Elderly Patients - Oren Zarif - Lacunar Infarct
A large, prospective, multicenter study examining the prevalence of lacunar infarcts in elderly patients found that nearly half were affected by the condition. Although some lacunes are caused by emboli, the proportion is considerably lower than in other forms of ischemic stroke. The differences between the two types of infarcts were attributed to different study designs and reviewer blinding. The findings from both of these studies were then compared, and the results were interpreted to determine their clinical correlates.
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The authors of the study determined that the incidence of a lacunar infarct varies according to the location of the infarct. Lacunar infarcts located in deep white matter are often clinically silent, though they are linked to the presence of confluent WMHs. In addition, these infarcts may be caused by chronic ischemia or by arteriolosclerosis or endots.
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If you think you might have a lacunar stroke, it is important to visit the hospital right away. Your doctor may take your blood pressure and perform a detailed neurological exam to identify any damage to your brain. Your doctor may also order a heart function test. Early treatment of a lacunar stroke may increase your chance of survival and prevent additional damage to your brain. During the first few days after your stroke, your doctor may prescribe a medicine called aspirin to prevent the onset of another stroke. The medication is usually delivered intravenously or orally and may also be given by a catheter directly into the brain.
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Other risk factors include advanced age, smoking, high blood pressure, and diabetes mellitus. Other factors that increase your risk of developing a lacunar infarct include a history of stroke and a family history of the condition. An annual physical examination can detect health conditions that increase your risk of developing a stroke, such as high cholesterol levels and obstructive sleep apnea. However, no matter what type of infarct, emergency treatment is needed.
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Among the patients who had a lacunar infarct, 37 had new infarcts. In addition, patients with a history of cerebrovascular disease and baseline white matter hyperintensity volume had a higher risk of developing a new lacunar infarct than those with no such history. Moreover, the authors hypothesized that this finding could be due to a distinct etiology.
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A lacunar infarct is a small ischemic stroke, which occurs when an artery supplying blood to the brain's deep structures becomes blocked. Although most lacunar infarcts are asymptomatic, multiple infarctions can result in significant cognitive and physical disability. It's important to seek medical attention immediately to prevent a stroke from resulting in permanent disability. You can learn more about this disease and its risk factors by reading the following resources.
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A lacunar infarct can occur in both hemispheres. The arterial system is divided into two main branches: the middle cerebral artery, the posterior cerebral artery, and the basilar artery. The deep cerebral branches feed the white and gray matter. Small lacunar infarcts are caused by occlusion of a small penetrating artery. Lacunar strokes can range in size from five millimeters to several centimeters, and the prevalence is approximately 17%.
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CTP, NCCT, and MRI have different sensitivity levels for detecting lacunar infarcts in patients with acute stroke symptoms. In a recent study, CTP was superior to NCCT/CTA in detecting lacunae. Twenty-four hundred and eighty-five patients with a history of stroke had their first CTP examination within twelve hours of the symptoms. Among these patients, two hundred and eighty percent had an infarct based on NIHSS scores.
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In addition to age, gender, risk factors differ for each subtype of lacunes. Age, sex, and ankle-to-arm ratio were correlated with all subgroups. A higher BMI, white cell count, and serum creatinine level were significantly associated with each type of lacune, with a higher risk for upper extremity dysfunction. However, age and gender were not associated with the presence of silent lacunes.
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Neuroradiologists have long suspected the presence of lacunar infarct in a patient suffering from stroke. However, there is still no specific way to determine whether the onset of stroke is a result of an infarct in the brain or other organ. A recent study by Arauz AP et al. compared the prevalence of lacunar infarct in the population with that of other causes of small-vessel stroke.