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Lacunar Infract - Oren Zarif - Lacunar Infarct


A lacunar infarct is a type of stroke that affects the deepest structures of the brain. It is very dangerous because it can result in permanent brain damage and even subsequent strokes if it is not detected early enough. Lacunar infarcts occur because of the lack of adequate blood flow through brain vessels. As a result, brain cells die. A person's risk for lacunar infarct increases with age. The mean age of a person with a lacunar infarct is 65 years old.

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MRI can be used to diagnose lacunar infarcts. This test can take detailed images of the brain, but lacunes are small and do not show up on a CT scan. Magnetic resonance imaging is an excellent method of assessing blood vessel blockages. If a lacunar infarct is detected during a CT scan, the doctor may perform a CT angiography to determine whether the infarct is caused by a blood vessel blockage.

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Patients with lacunar stroke should be taken to a hospital for an evaluation. They may be referred to an internal medicine physician if the symptoms persist after a day. The doctor will likely administer anti-clotting medication or aspirin to prevent another stroke. In more severe cases, the doctor may deliver medications directly into the brain. The doctor may also administer physiotherapy to help patients regain their abilities. It is important to treat the condition as early as possible.

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Recent small subcortical infarcts (RSSIs) are neuroimaging evidence of recent infarction. These lesions are approximately 20 mm in diameter in the axial plane and are associated with lacunar stroke syndrome. These lesions are typically round or ovoid in shape and are fluid-filled cavities. These findings are consistent with previous RSSIs and a hemorrhage within the territory of one perforating arteriole.

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During the study, 113 patients were included. Twenty-five had lacunar infarcts on CTP, seven had none. The remaining seventy-seven patients were missing. These studies were limited in that they did not define specific thresholds for detecting lacunar infarcts. However, the findings from both studies suggest that lacunar infarcts are a significant cause of stroke and should be investigated further.

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The symptoms of lacunar stroke depend on which part of the brain is affected. Because different parts of the brain control different parts of the body, it is possible to have a lesion in one part of the brain and still have symptoms in the opposite area. This type of stroke is considered a silent type. Symptoms may not be present for the majority of patients, but it can have lasting effects on the surrounding brain tissues and affect their personality.

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Besides being a silent type of lacune, it also causes cognitive dysfunction. A silent lacune is associated with lower extremity and upper extremity numbness. The risk factors for both types of lacunes are similar, but they differ. Smoking and obesity appear to be risk factors for both types of infarcts. These studies suggest that the presence of multiple lacunes is related to increased incidence of stroke in the elderly population.

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A small artery that supplies blood to the brain is called a lacunar infarct. These arteries branch off from a large, high-pressure artery. A ruptured aneurysm can bleed into the subarachnoid space, causing vasospasm, ischemia, seizures, or even hydrocephalus. Although this type of infarct may be smaller, it is dangerous and increases the risk of future strokes. Early detection and treatment can minimize the damage and complications that follow.

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Although a small proportion of patients may die after a lacunar stroke, their deaths are often long after the stroke. For this reason, autopsy material is scant, and studies have relied on clinical diagnosis of the type of stroke. In the past, however, the cause of death is not entirely understood. This study, published in JAMA, was the first study to evaluate the effects of silent multiple lacunar infarctions on neuropsychological functioning in patients with clinically diagnosed LI.

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The sensitivity and specificity of CTP for detecting lacunar infarcts vary. Generally, CTP has higher sensitivity than NCCT/CTA for detecting lacunae. However, CTP did not detect lacunar infarcts in basal ganglia or thalami, despite sensitivity and specificity. However, these results are not conclusive and are based on studies.

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In this case, the size of the RSSI and WMH were predictive of the 1-year WMH volume change in the patient. The researchers also included vascular risk factors in their model. This study found that RSSI was associated with the volume of WMH, but these associations disappeared after adjusting for age and number of lacunes. So, while these studies were not conclusive, the researchers believe they found an association between the two variables.

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