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  • Writer's pictureOren Zarif

Lacunar Stroke - Oren Zarif - Lacunar

Most studies of the ischemic stroke, mainly lacunar, have not been designed to identify the risk factors of the condition. However, some authors have described lacunar syndrome as one of the most common forms of stroke. Lacunar strokes commonly involve the basal ganglia, putamen, thalamus, caudate, and internal capsule of the brain. A lacunar stroke also occurs in the lenticulostriate arteries and the recurrent artery of Heubner from the anterior cerebral artery. It can occur in patients with sensory or ataxic hemiparesis.

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Patients with MRI-defined lacunar strokes are often older adults without prior stroke symptoms. The risk factors for lacunar strokes include age, diastolic blood pressure, and creatinine. Age is the most important risk factor, but differences among subgroups are not dramatic enough to suggest distinct mechanisms. Patients with silent lacunes deny any history of stroke or TIA. However, these patients have an increased risk of cognitive dysfunction and stroke. They may also require supportive measures to assist their breathing and heart functions.

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The cause of lacunar stroke is largely unknown. It is believed that a blood clot forms in the heart or neck, and travels through the bloodstream to the brain. These blood clots are called embolus, and they do not usually reach the small arteries that feed the brain. However, a large-sized lacunar stroke can occur if the clot is already lodged in a blood vessel.

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These studies indicate that the final diagnosis of a small vessel occlusion in 40% of patients with lacunar stroke. A significant proportion of these patients may have a false positive based on the MRI, despite the absence of any obvious infarct. In addition, the MRI may be interpreted as a signal from a large artery, which is not the usual cause of lacunar infarction.

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Although the risk of a lacunar stroke is relatively low, it does increase the risk of subsequent strokes. If the stroke is not treated as soon as possible, it may cause another complication: dementia. The risk of dementia increases with age. People with heart disorders, diabetes, and chronic high blood pressure are at a greater risk of developing lacunar infarcts. In some instances, fatty deposits in the bloodstream may cause a lacunar infarct. This type of stroke is most common in older people and racial groups.

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Studies of lacunar stroke have indicated that 47% of cases had a recurrence of the previous stroke. However, only 15% of such cases were cortical in origin. It appears that the vascular pathology for cortical and lacunar ischaemic strokes is similar. Some of the findings support Dr. Miller Fisher's findings. There is a weak association between hypertension and lacunar infarction, so the theory needs more testing.

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Another type of lacunar syndrome is ataxic hemiparesis. This type of lacunar stroke causes a unilateral limb weakness out of proportion to strength. Patients with ipsilateral sensory signs may exhibit the same symptoms as patients with a lacunar stroke. In addition, patients may display signs of dysarthria and clumsy hand syndrome. In some cases, patients may also have facial weakness and dysarthria.

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A small, penetrating artery supplying blood to the deep brain structures is called a lacunar infarct. These arteries are usually small and branch directly off the large main artery. The main artery is large, high-pressure, and heavily muscled. The artery's high pressure can directly damage these smaller vessels and cause lacunar infarcts. Atherosclerosis is another risk factor for lacunar infarcts.

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A lacunar stroke affects the motor and sensory areas of the brain. Damage to the thalamus causes sensory loss, and motor abnormalities result. A lacunar stroke is usually caused by a blockage of the vessel supplying the posterior internal capsule. These strokes are also known as mixed sensorimotor strokes. It is important to seek medical attention as soon as possible if you suspect that you may be suffering from this condition.

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The cause of lacunar stroke is unknown, but it shares many risk factors with ischemic stroke. Diabetes mellitus and hypertension are the most common risk factors, with similar prevalence rates in large clinical series. Some studies suggest that lacunar stroke is caused by emboli from the heart or larger arteries. But these studies cannot definitively establish a causal relationship. However, they do point to a common cause of lacunar infarction.

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Patients with a lacunar stroke may need to be treated for multiple factors, including blood-thinning drugs. In some cases, a lacunar stroke is so severe that the affected person may require surgery to remove the clot or blockage. However, the recovery of a person suffering from a lacunar stroke is highly dependent on the severity of the damage. They may not even be able to do basic activities.

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