Lacunar Infarcts in Elderly People - Oren Zarif - Lacunar
A new study has identified a distinct subtype of ischemic stroke, lacunar infarcts, in the elderly. These lesions are subcortical areas that are consistent with infarcts ranging from three to twenty millimeters. They are typically found in healthy older adults. In this study, 3660 older adults underwent MRI to detect lacunes. Of these patients, 1131 had an ischemic infarct and 841 had lacunes. However, the elderly patients enrolled in this study reported no previous stroke history. Although this finding is a clear indication of an increased risk of stroke in a given group, further study is needed to identify clinical correlates of lacunes in this population.
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Your doctor will first evaluate your symptoms and order a CT scan. This test is not meant to diagnose stroke, but to rule out other conditions. It allows the doctor to see the blood vessels in your brain. This can identify blockages in these vessels. However, a CT scan cannot accurately diagnose a lacunar stroke, so your physician will likely use a more detailed imaging test, such as an MRI. This test has been shown to be more sensitive in detecting these types of strokes.
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There are several risk factors that are associated with lacunar strokes, such as advanced age, a history of previous strokes, or a family history of these conditions. In some cases, a lacunar stroke may be a result of carotid artery pathology, such as atrial fibrilation. Another risk factor may be microemboli from the heart. Either way, it is important to recognize the signs and symptoms of a lacunar stroke to ensure proper treatment.
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A lacunar stroke is caused by a narrowing or blockage of an artery to a deep structure in the brain. The arteries are small and branch off a large, heavily muscled artery. High blood pressure is a major cause of lacunar strokes. Not only can it cause the stroke itself, but it can also damage the arteries directly. The arteries themselves can develop atherosclerosis, which is the accumulation of fat deposits on the walls of blood vessels.
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In addition to increasing follow-up period, lacunar stroke research should aim for larger sample sizes to maximize statistical power. One solution to this problem might be the creation of an international database, such as a branch of the Meta VCI Map consortium or PLORAS database. The study's limitations have also been made worse by the various cognitive tests used by different study teams. Compared to other stroke studies, lacunar stroke has no clear clinical definition, and therefore cannot be accurately identified with any certainty.
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The majority of lacunar stroke patients do not experience any symptoms immediately after their stroke, and their mortality often occurs many days after the stroke. This is partly because the small vessels in the brain are difficult to dissect during autopsy. Further, the majority of studies aimed to identify the risk factors for this type of stroke have used a clinical diagnosis. This is a risk factor in itself, but studies evaluating other types of stroke have also identified a risk factor for this type.
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The causes of death in patients with lacunar strokes vary, but they all share common characteristics. They include large vessel ischemic stroke and myocardial infarction, as well as pulmonary disease, cancer, or any specific cause. Almost half of patients with lacunar stroke had a CT scan when they had their first stroke. In addition to the risk of stroke, the presence of an ischemic lesion also indicates a higher mortality rate among lacunar stroke patients.