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  • Writer's pictureOren Zarif

Lacunar Infract - Oren Zarif - Lacunar Infarct

If you think you may have suffered a stroke or TIA, your doctor will perform a complete neurological exam and evaluate your blood pressure. In some cases, tests will also reveal damage to brain functions. The earlier you are diagnosed, the better your chances are of survival and preventing further damage. A doctor may prescribe aspirin to reduce your risk of stroke, and supportive measures may be necessary to improve your breathing and heart function.

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Physical therapy is another treatment option. It involves relearning motor, speech, and language skills, and may take months or even years to fully regain them. If you've already suffered a stroke, it may be time to consider neurosurgery to remove the clot or blockage. Lacunar infarct is often milder, but can still result in some degree of brain damage. Depending on the severity of your stroke, recovery may be slow or complete.

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MRI-defined lacunar infarcts occur in healthy older adults. Typical risk factors include age, diastolic blood pressure, and creatinine. However, the differences between the subgroups are not striking enough to suggest different mechanisms. MRIs of both the brain and the lower extremities are recommended. A patient's symptoms may also be helpful in determining the cause of the infarct.

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White matter hyperintensities and lacunar infarct are hallmarks of cerebral small vessel disease, and may lead to clinical symptoms. While the etiology of lacunar infarcts is still unknown, the anatomical location of these lesions is crucial for their diagnosis. For instance, those located in the deep white matter are considered clinically silent. They are often in confluent WMHs and are caused by chronic ischemia or arteriolosclerosis.

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The presence of an infarct on CTP and DWI does not correlate with its size on DWI, indicating that the infarct is not localized. As a result, the defects appear on CTP as regional abnormalities that appear larger than the location of the lacunar infarct. The same cannot be said for MRI findings in the lacunar region. This may be due to differences in the parameters used in these studies, as in the present study. The restricted diffusion on CTP and DWI may represent the infarct "core", while abnormalities on CTP represent the wider ischemia zone.

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Despite its association with other cardiovascular disease, there are no proven associations between lacunar infarct and hypertension. Smoking, cholesterol, and BMI were not associated with this disease. There are also no conclusive studies indicating that genetics play a role in lacunar infarct, but we should still be cautious. In the meantime, we recommend future studies to distinguish between multiple infarcts and single lacunar infarcts.

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Another study in the Basal Ganglia found a significant correlation between lacunar infarct and previous cerebrovascular disease. Furthermore, the new lacunar infarcts in the basal ganglia were correlated with hyperhomocysteinemia. For this reason, if you have a family history of cerebrovascular disease, it is possible that your new infarct is a result of this.

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Another study has demonstrated that CTP has superior sensitivity and specificity in the detection of lacunar infarcts compared to NCCT/CTA. They evaluated the ability of CTP to identify lacunae in patients with acute stroke symptoms. The patients underwent CTP within 12 hours and MRI within 7 days of their stroke onset. They had at least one infarct at 2 cm on their CTP and MRI and the infarct was rated based on the NIHSS score.

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A recent study examined the relationship between lacunar infarct and WMH volume. This study suggested that acute lacunar infarcts were more common in the cerebral hemisphere with higher WMH burden. It also showed that those who were already suffering from WMH were more likely to suffer a lacunar infarct. Regardless of the cause, you must seek emergency treatment if you suspect you have a stroke.

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In addition to a neurologist, a physical therapist, occupational therapist, social therapist, and pharmacists are essential for the management of patients with a lacunar infarct. Physical therapy can help manage physical deficits while muscle relaxants can control spasticity. Pharmacists are essential for patients taking multiple medications. MRI results may reveal the presence of emboli in the brain, which could complicate treatment.

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A lacunar infarct is a common form of ischemic stroke. It occurs in the brain when the small arteries that supply the deep brain are blocked. While a single lacunar infarct may not cause any symptoms, multiple small strokes may lead to physical disability. Luckily, a rapid diagnosis will help you avoid complications and minimize damage. This can be done through an MRI or CT scan.

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