Lacunar Infarcts in the Elderly - Oren Zarif - Lacunar
The prevalence of MRI-defined lacunar infarcts was comparatively high among older adults. In the Cardiovascular Health Study (CHS), 3660 elderly subjects were examined for MRI. Among them, 1131 had ischemic infarcts and 841 had lacunes. In the study, however, only one-fourth of the participants had any history of stroke or any previous vascular disease. Although these results are encouraging, more studies are needed to determine the role of lacunes as indicators of subsequent risk for stroke.
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Although the cause of lacunar strokes remains unclear, blood clots in the heart and neck can form and travel through the bloodstream to the brain. These clots, known as embolus, are unable to travel through small arteries and therefore do not reach the brain. The authors suggest that a higher proportion of lacunes is silent. Therefore, the occurrence of lacunes is a cause for concern.
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Advanced age is a major risk factor, as are chronic hypertension, alcohol consumption, and smoking. A history of previous stroke also increases the risk for lacunar strokes. However, in rare cases, carotid artery pathology may cause lacunar strokes. Similarly, atrial fibrillation can lead to microemboli to the brain. Although patients usually recover from lacunar strokes, if the stroke causes damage to the brain, a patient may develop a subcortical dementia.
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In addition to the association between risk factors and the occurrence of lacunar infarcts, there are also some other risk factors that may increase the risk of developing these infarcts. A previous history of cerebrovascular disease or an increase in baseline white matter hyperintensity volume may contribute to the increased risk of developing lacunar infarcts. The use of antihypertensive drugs is also linked with increased risk of developing lacunar infarcts.
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Risk factors for lacunar infarcts may differ in the elderly. However, they are associated with the progression of WMH. This is a promising result, and it may explain why there are so few new cases. However, the risk of developing these new infarcts is similar among both sexes. This study highlights the need for research in this area. This study supports the importance of early diagnosis and treatment for this condition.
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In addition, age and sex were strongly associated with the risk of developing lacunes. In addition to age, other risk factors associated with lacunes were the presence of internal carotid artery stenosis, ankle-to-arm ratio, and serum creatinine level. Various blood pressure measures and the level of white blood cells were significantly associated with all types of lacunes. A study on lacune risk factors found that the extent of stenosis in the internal carotid artery and the number of cases of this condition.
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A lacunar stroke is a type of ischemic stroke, where a blood vessel that supplies blood to the deep structures of the brain is blocked. These arteries are small and branch off of the large main artery, which is heavily muscled and high-pressure. In addition to causing lacunar infarcts, high blood pressure directly damages the arteries, resulting in atherosclerosis, the fatty depositing on the walls of blood vessels.
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Other strokes may have similar risk factors to lacunar infarcts. Hypertension and diabetes mellitus are the two most common risk factors. Larger clinical series have consistently documented these risk factors in lacunar infarcts. However, the prevalence of these factors is debated. One study found that only 2.6 percent of patients with lacunar infarcts had hypertension and diabetes mellitus.
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A lacunar infarct is typically caused by a deep penetrating branch occlusion, although other stroke subtypes can produce it. Despite this lack of definite causes, these rare strokes can be difficult to distinguish from other ischemic strokes. A large part of the diagnosis is based on clinical presentation. There are also some clinical indicators that may help distinguish the lacunar syndrome from other types of stroke.