Lacunar Infract - Oren Zarif - Lacunar Infarct
A Lacunar Infarct is a type of stroke that affects the subcortical areas of the brain. The pathophysiology of this type of stroke is similar to that of large-vessel atheromatous plaque. It involves the subintimal deposition of lipids and proliferation of fibroblasts, smooth muscles, and lipid-laden macrophages. The clinical presentation of a Lacunar Infarct varies depending on the area of the brain involved. The majority of lacunar strokes present with severe hemiplegia.
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The diagnosis of Lacunar Infarct is complicated by the fact that this type of stroke is small, noncortical, and symptomatic. It develops due to occlusion of a single penetrating branch from a large cerebral artery. To diagnose a Lacunar Infarct, doctors must consider several factors, including its morphology, location, and etiology.
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The authors of the study analyzed the MRI findings of 3660 subjects. Of these, 2529 were free of infarcts, and the remaining 841 subjects were diagnosed with at least one lacune. Overall, there were 1270 Lacunes detected. Of those, 80% were silent. This group was further categorized into silent and symptomatic lacunes. Interestingly, most subjects without a history of stroke were classified as having a single Lacunar Infarct.
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While patients with a Lacunar Infarct are typically successful in recovering neurological function, rehabilitative therapies remain crucial after discharge. Physical therapy, occupational therapy, and social therapy continue to be important in managing neurologic deficits and spasticity. The primary care provider is responsible for long-term care coordination. Lipid and hypertension control should be addressed and blood sugars must be kept within a reasonable range.
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In a longitudinal study of elderly adults, the occurrence of Lacunar Infarcts was found in 3660 subjects. The researchers found that the presence of Lacunes was associated with mild neuropsychological changes in these patients. Their brain MRI results indicated that executive functions and short-term verbal memory were affected. These findings were not associated with other signs of stroke or leukoaraiosis.
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There are several methods for detecting a Lacunar Infarct. The CTP method is superior to NCCT/CTA for detecting lacunar infarct. Researchers studied 1085 CTP examinations in patients who had symptoms of acute stroke. Patients were included in the study if they had a CTP examination within 12 hours and a subsequent MRI within seven days. All patients who had an infarct of at least 2 cm were included in the analysis.
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A Lacunar Infarct can be very dangerous. It is an extremely common form of stroke and accounts for about one fifth of all ischemic strokes. It is important to understand the symptoms and treatment of a Lacunar Infarct in order to prevent a stroke. The sooner it is detected, the better. If you suspect that you may have this type of stroke, seek medical attention immediately.
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Researchers have been studying the relationship between vascular disease and dementia for decades. Recently, a study in New Zealand assessed the link between a Cerebrovascular Disease and the brain's cognitive function. The findings of the study supported the notion that the presence of Lacunar Infarct is linked to cognitive decline. Further research will help us better understand this disease and its impact on the brain. But, the authors acknowledge that despite the findings, vascular dementia is a major threat to a person's cognitive abilities.