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  • Writer's pictureOren Zarif

Lacunar Infract - Oren Zarif - Lacunar Infarct

The mechanism behind the formation of lacunes remains unclear. It has been suggested that lacunes may be caused by emboli in larger arteries or from the heart. The authors cannot establish causality from cross-sectional observational studies. However, they could state that the majority of lacunes are silent. This finding has important implications for the diagnosis and treatment of lacunar infarct. The study also highlighted the importance of identifying lacunes as early as possible, to minimize the risk of a stroke or TIA.

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Acute lacunar infarcts are more likely to occur in cerebral hemispheres with more WMH. Furthermore, patients with asymmetric WMH may be at increased risk for a subsequent lacunar infarct. As a result, clinicians should consider the presence of lacunar infarcts as early warning signs of a larger stroke. And since they do not result in monoparesis, clinicians should consider them when considering the diagnosis of a patient with a CSVD.

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Despite these findings, lacunar infarcts remain mysterious to many. They tend to present as 'pure syndromes,' and do not typically affect higher cortical functions. However, a careful investigation of the cause of lacunar strokes may help target effective secondary prevention regimens. In the meantime, more research is needed to learn how these strokes develop, and to determine if there is a specific risk factor for the development of these lesions.

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One patient with a suspected lacunar infarct presented with symptoms such as difficulty lifting his left arm. The patient was admitted to a physical therapy department, but not cured. The physical examination revealed weakness in flexion and extension of the left forearm and increased deep tendon reflexes. Neuroimaging examination revealed a lacunar infarct near the right lateral ventricle. Other cardiac and laboratory tests were normal.

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Recent small subcortical infarcts were classified as lacunar infarcts and were associated with a lacunar stroke syndrome. The clinical characteristics of these lesions differ between the two types of stroke. Infarcts may be caused by embolism or fibrinoid degeneration. However, repeated episodes may cause vascular dementia. There is no specific treatment for lacunar infarct.

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Treatment for a lacunar infarct is similar to that of an ischemic stroke. The brain is deprived of oxygen within minutes of the stroke. Thrombolysis is performed to break up blood clots. A mechanical device is also used to remove blood clots. The patient is also prescribed blood-thinning drugs for 90 days following the procedure. A physiotherapy session may be useful for recovering abilities lost after the infarct.

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Another difference between the two types of infarcts is the location. Patients with an infarct in the basal ganglia are more likely to have a history of cerebrovascular disease. This suggests that this condition is not caused by small arteries. The risk factors for a lacunar infarct vary by location. There was a strong correlation between the occurrence of an infarct in the basal ganglia and a history of the disease.

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A large study involving over 300 patients analyzed the prevalence of lacunar infarcts in basal ganglia and deep white matter. Twenty-four patients had new infarts, with only one study examining the relationship between baseline vascular risk factors and subsequent infarcts. The authors hypothesized that patients with infarts in basal ganglia or deep white matter have different risk factor profiles.

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MRI imaging revealed that there was a strong association between age, sex, and creatinine levels and lacunes. Age and gender were also strongly associated with each subgroup. Furthermore, having MRI evidence of lacunes was associated with having a higher internal carotid artery stenosis than 50 percent. Although the study did not examine the cause of lacunes, it does reveal that the risk factors for each of these three types differ significantly.

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Acute symptoms of lacunar infarct may not appear for many years, but patients may eventually recover. The chances of developing another lacunar infarct are approximately 11% for people who've suffered a previous stroke. People with older age and a history of depression are at increased risk for another stroke. However, younger patients who've had a lacunar infarct are less likely to experience disability afterward.

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Early detection of lacunar infarcts is essential in preventing a stroke. Acute lacunar infarction is associated with mild neuropsychological deficits, such as impaired executive functions and short-term memory. If detected early, it can reduce the risk of future strokes and reduce the damage to brain tissue. If you're a victim of lacunar infarct, it is critical to contact a doctor as soon as possible.

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