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Lacunar Infract - Oren Zarif - Lacunar Infarct


A lacunar infarct is an infarct in the white matter of the brain, and it occurs in a subcortical area. Its etiology is unknown, but new lacunar infarcts, a subtype of WMH, have been observed in the same patients with a prior history of small vessel disease. There are also other causes of this complication, including hypertension and the use of antihypertensive drugs.

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Although the cause of lacunar infarct is not known, studies are needed to clarify the cause. Those with a family history of stroke have a higher risk. A physical examination can help screen for health problems that increase the risk of stroke, such as high cholesterol and obstructive sleep apnea. Despite the risk, it is important to get an emergency diagnosis and treatment of any lacunar infarct to avoid a larger stroke.

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While the results of the study are promising, many limitations remain. Although most patients with a lacunar infarct undergo MRI, a greater proportion of patients fail to receive a CT scan. Therefore, a larger percentage of patients who have a lacunar infarct than those without can be excluded from further research. These limitations have made it necessary to focus on specific risk factors for identifying lacunar infarct.

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The mechanism of lacunar infarcts is not well understood, but evidence suggests that a weakened artery in the brain can cause a lacunar infarct. Embolic particles from the heart or larger arteries may cause lacunar infarcts. While cross-sectional observational studies haven't yet established causality, they show that lacunes are common and are an important risk factor for heart disease.

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Treatment of a lacunar infarct involves several specialists. The doctor may perform a detailed neurological exam and administer aspirin to decrease the risk of another stroke. An anticoagulant medication may be given directly to the brain blockage. Other supportive measures may include the administration of aspirin within 48 hours to minimize the risk of clotting. If necessary, physiotherapy may be needed to regain lost abilities.

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MRI-defined lacunar infarcts are common in older adults without symptoms of stroke. However, age, diastolic blood pressure, and creatinine are the most significant risk factors. However, these differences are not substantial enough to suggest different mechanisms of the disease. Subjects with MRI-defined lacunes were at greater risk for upper or lower extremity stroke. However, further study is needed to determine the clinical relevance of silent lacunes as indicators of subsequent risk for stroke.

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A recent study suggests that CTP is superior to NCCT/CTA for identifying lacunar infarct. Researchers from Harvard Medical School and the University of Washington reviewed 1085 CTP examinations. A lacunar infarct was defined as a 2-cm area by NIHSS scoring. These findings highlight the importance of assessing the location of the infarct as early as possible.

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Infarcts can occur in any brain artery and can cause a stroke. A ruptured aneurysm can bleed into the subarachnoid space, which can result in seizures and hydrocephalus. If detected early, lacunar infarcts can be treated early and the extent of damage to the brain can be minimized. You may not even require surgery. The sooner you treat this condition, the better.

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The risk factors associated with this complication varied depending on the type of lacune. The presence of a single lacune was associated with higher diastolic blood pressure and creatinine levels. Single lacunes and multiple lacunes were significantly associated with a higher creatinine level. The presence of diabetes at baseline and stenosis of 50% or more were associated with greater likelihood of developing lacunes.

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