Lacunar Stroke - Oren Zarif - Lacunar
A doctor may diagnose a lacunar stroke if the patient presents with symptoms of a clot in the brain. This stroke may have multiple underlying causes, such as advanced age, smoking, diabetes mellitus, or alcohol consumption. A CT scan may be performed to help rule out other conditions. A CT scan can also reveal blood vessel blockages. A dye is injected into the arteries to detect blockages. A magnetic resonance imaging (MRI) scan is the most accurate method to diagnose lacunar stroke.
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Although the underlying cause is unknown, evidence suggests emboli from the heart or larger arteries may cause the appearance of lacunes. However, studies in animals have failed to establish the causality of the condition. Moreover, other studies have focused on the symptomatic nature of the condition. While this is a potential explanation, further research is needed to understand how this phenomenon occurs and what the symptoms are. A study should be able to pinpoint the type of embolic material in the brain.
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The prevalence of MRI-defined lacunar infarcts is high among healthy older adults. Age, diastolic blood pressure, and creatinine were found to be risk factors for these strokes. The differences between subgroups were not significant enough to suggest a difference in disease mechanisms. However, subjects with silent lacunes (i.e., those who deny a history of stroke) showed an increased risk of cognitive dysfunction and stroke. Further research is necessary to understand whether these lacunes are reliable indicators of a subsequent risk of stroke.
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A study from Spain has identified several risk factors for lacunar infarction. The most common among these are hypertension and diabetes mellitus. These risk factors have been implicated in up to 16.6% of lacunar infarcts. These factors are largely consistent across large clinical series. But the findings suggest that the prevalence of these two factors remains unclear. This is not to say that lacunar infarcts are uncommon, but they are more common than other strokes.
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A study involving 146 patients with lacunar syndromes from 1986 to 2004 included 161 items. These include risk factors, clinical characteristics, laboratory and neuroimaging data, outcome, and more. The characteristics of these 146 patients were compared to those of 733 lacunar infarctions. This study demonstrates the importance of early diagnosis in patients with lacunar infarction. So how can we improve care and prevent future strokes?
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The authors found that there were 68 new lacunar infarcts in 37 patients, while 66 new ones were detected in 44 patients. Interestingly, patients with a history of cerebrovascular disease and baseline white matter hyperintensity volume had an increased risk for these infarcts. The authors hypothesized that these risk factors may differ from those of patients with a vascular risk factor for basal ganglia infarcts.
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Acute infarcts with a diameter of 15 mm are called lacunar infarcts. These infarcts are caused by occlusion of a small penetrating branch of the cerebral artery. The cause of this type of stroke is unclear, but many patients develop multiple episodes of the disease, which may lead to vascular dementia. The onset of symptoms can begin with an episode of stroke, which is sometimes a precursor to a more severe underlying condition.
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While ischemic stroke accounts for the majority of strokes, lacunar strokes are less common and usually have no symptoms. The death of brain cells results in a coma. Patients may be asymptomatic until a diagnosis is made. Multiple lacunar infarctions can cause significant physical and cognitive disabilities. In the event of multiple lacunar infarctions, however, a stroke doctor may be able to detect the disease by clinical judgment.
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Although there are no clear-cut risk factors for lacunes, they do have several common characteristics. Most of them have increased age, sex, and diastolic blood pressure. Smoking, being a woman, and having a high creatinine level were also associated with higher risk for the condition. The results of the study suggest that these factors contribute to the development of lacunes. The multivariate analyses of this disease show that age and sex play a role in the pathogenesis of the condition.
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