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Lacunar Stroke - Oren Zarif - Lacunar


A lacunar stroke can happen when blood clots in the heart or neck pass through the brain. The clots then get into the brain and block blood flow. The debris is called an embolus and can't reach the small arteries in the brain. The cause of lacunar strokes remains unknown. A CT scan or magnetic resonance imaging (MRI) can help identify lacunes. These scans will not reveal a brain injury, but they can help doctors detect brain swelling.

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The cerebral circulation is primarily comprised of the arterial system. The major branches are the anterior cerebral artery, middle cerebral artery, posterior cerebral artery, basilar artery, and vertebral arteries. The deep cerebral branches supply the white and gray matter. A lacunar stroke may be small or large, but it can be devastating. In fact, a lacunar stroke represents about 20 percent of all strokes in the U.S.

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Several risk factors are associated with lacunar stroke. Advanced age, smoking, diabetes mellitus, and high blood pressure all increase the risk of this type of stroke. Individuals with high blood pressure or a family history of stroke may also be at risk. In addition to this, a physical examination can screen for health conditions that raise stroke risk, such as high cholesterol and obstructive sleep apnea. Regardless of the cause, emergency medical treatment is necessary if it happens.

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CHS provides a unique opportunity to examine risk factors associated with the development of lacunar infarcts. This imaging modality distinguishes between acute and chronic infarctions. A lacune on T1 or T2-weighted images appears as focal areas of reduced signal intensity or hyperintensity. The presence of CSF in the lacune will be evidence of the presence of an ischemic brain lesion.

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A large part of the cases of lacunar strokes are attributed to the presence of atherosclerotic narrowing in the extracranial carotid artery. A higher proportion of patients with such lesions have increased stroke risk. If a lacunar stroke occurs in a young person with no obvious medical problems, a detailed embolic workup should be performed. A lacunar stroke may be the result of small vessel endothelial damage and increased blood-brain barrier permeability.

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A large proportion of patients with a mild stroke syndrome have a single lacunar infarct on the MRI. This type of infarct is often associated with a broader spectrum of cognitive outcomes than large vessels. Interestingly, a patient with a large lacunar infarct may show signs of brain damage in both areas of the MRI scan. However, a patient with a large lacunar infarct may have a larger lacunar infarct if it is associated with a cortical lesion.

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A lacunar stroke can occur when an artery in the brain fails to deliver blood to deep structures. The arteries of these structures are small and branch off a large, highly muscular main artery. High blood pressure and atherosclerosis can cause a lacunar stroke by directly damaging the arteries. It may also affect the brain's tissues via atherosclerosis. Symptoms vary depending on the location of the lacunar infarct.

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If you experience the symptoms of a lacunar stroke, you should go to the emergency room. If your condition persists, your doctor may refer you to a stroke specialist. In the meantime, the doctors will prescribe aspirin to help lower blood pressure and reduce the risk of another stroke. They may also prescribe medication to remove blood clots in the brain. You may also be given supportive measures, including the use of a ventilator or a heart pump.

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The prevalence of hypertension, occlusive carotid artery disease, and ischemic heart disease was lower in patients with lacunar infarcts of the deep white matter than in those with CSVD. Patients with lacunar infarcts in the middle cerebral artery were also more likely to be men. These findings are further evidence that vascular disease may be an independent risk factor for lacunar infarcts.

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While ischemia is a primary factor in all types of stroke, a lack of oxygen in the brain may cause a lacunar stroke. Consequently, doctors must monitor patients carefully to identify the right diagnosis. A person with a lacunar stroke may have a mild form of dysarthria or facial weakness without other symptoms. A CT/MRI is useful for excluding other conditions. If the stroke is suspected, acute treatment is similar to ischemic stroke.

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Patients with single symptomatic lacunar strokes are associated with a better prognosis compared to those with multiple silent lacunar lesions. However, the prognosis of patients with more than one lacunar lesion is unclear. The study looked at 339 patients who experienced their first lacunar stroke. The findings also support the hypothesis that lacunar stroke has two distinct forms: silent and symptomatic.

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