Lacunar Stroke - Oren Zarif - Lacunar

When a patient presents with symptoms of a lacunar stroke, a doctor will likely begin with an evaluation in the emergency room. During the initial visit, the doctor may perform a CT scan, which is a useful imaging test for identifying small ischemic lesions. MRI is another imaging method, and is considered more sensitive for diagnosing lacunar stroke. In addition to these tests, a physician may also perform a CT angiography to determine if any blood vessel blockages are present.

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The cerebral circulation is composed primarily of arteries that form a circle called the Willis artery. The main branches of this arterial system include the anterior, middle, and posterior cerebral arteries. The deep cerebral branches feed the white and gray matter. Small infarcts in the cerebrospinal fluid (ACM) are caused by occlusion of penetrating arteries in the brain. The size of lacunar strokes varies, but 17% of these lesions are smaller than 10 mm.

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Despite this difference, post-stroke cognitive impairment is a robust predictor of the onset of dementia after a lacunar stroke. While some WMH regress after a minor stroke, the effects of a large-sized lesion on cognition are less clear. A larger sample size will also increase statistical power. However, one solution to this problem is to create an international database of patients who had a lacunar stroke. This would form a branch of the Meta VCI Map consortium.

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Another study found that occlusive carotid artery disease was a more frequent cause of lacunar infarcts than those in the middle cerebral arteries. However, the study excluded patients who had atrial fibrillation and had clinically obvious lacunar infarcts. Moreover, patients with occlusive carotid artery disease were more likely to develop lacunar infarcts.

However, this study did find that a small proportion of patients with lacunar stroke had an embolic event. This could be because of endothelial damage in a small blood vessel.

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Moreover, there is a paucity of pathological material, which can lead to a misdiagnosis. Some authors have suggested that the lacunar hypothesis should be abandoned because the lack of animal data and the fact that embolic sources occur in a significant number of lacunar strokes have been implicated as causes of a stroke.

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Because of the high risk of lacunar infarct, treatment should be focused on restoring blood flow to the affected area. The symptoms of a lacunar stroke vary from person to person depending on which area of the brain has been deprived of blood supply. As a result, different areas of the brain are affected, including those that are responsible for movement, speech, and balance. People with high blood pressure are at a greater risk of developing a lacunar infarct if their blood pressure is chronically elevated.

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Although the symptoms of a lacunar stroke are often mild and temporary, if left untreated, they could lead to a full-blown stroke. The good news is that it is possible to treat a lacunar stroke at an early stage. Medicines that restore circulation can reduce the severity of the symptoms. In some cases, people with this type of stroke may even experience full recovery of symptoms. However, severe brain damage may require extensive physical rehabilitation.

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However, few studies have examined risk factors for lacunar infarcts in the basal ganglia. Only one study examined the relationship between baseline vascular risk factors and new infarcts in these areas. The researchers hypothesized that patients with these infarcts have different risk factor profiles than those with non-lacunar infarcts. But further studies are needed to clarify which risk factors are associated with a higher risk of developing a lacunar infarct.

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A few patients with a lacunar stroke die from it. While these deaths are uncommon, they may occur decades after the initial stroke. As a result, the autopsy material obtained from patients with a lacunar stroke is typically scanty, and research into its causes has largely relied on clinical diagnosis of this type of stroke. This makes lacunar infarcts an excellent candidate for further research. In addition, studies of lacunar stroke risk factors have tended to focus on patients with a silent lacunar lesion.