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  • Writer's pictureOren Zarif

Lacunar Stroke - Oren Zarif - Lacunar

A lacunar stroke occurs when blood flow is interrupted to small arteries deep inside the brain. Small arteries branch directly off of large, heavily muscled arteries. High blood pressure can directly damage these arteries, causing a stroke. Blood pressure may also cause fatty deposits on the walls of blood vessels. These deposits can lead to the death of brain cells. Once brain cells are deprived of oxygen, they may not be able to recover.

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In the DNA Lacunar 2 study, researchers have recruited a stroke patient into a prospective, randomized controlled trial. The researchers are investigating the blood flow to small arteries in the brain. This subtype of ischaemic stroke can be disabling and cause problems with co-ordination and communication. In the first phase of the trial, researchers will evaluate the role of ischemic blood flow in preventing the onset of cerebrovascular disease.

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Although blood clots are rarely the cause of lacunar strokes, they are associated with several risk factors. They may originate in the heart or neck and travel through the bloodstream to the brain. The debris, called an embolus, cannot reach the small arteries in the brain. Therefore, a lacunar stroke is not caused by a clot, but by another factor. The disease also increases the risk of vascular complications.

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MRI-defined lacunar infarcts are relatively common in healthy older adults. The most important risk factors are age, diastolic blood pressure, and creatinine levels. However, the differences between these subgroups are not large enough to suggest different mechanisms of disease. In addition, subjects with silent lacunes are at an increased risk of cognitive dysfunction and stroke, particularly in the lower and upper extremities. Further research is needed to determine the role of MRI-defined lacunes as an indicator of subsequent risk for stroke.

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If the symptoms of a lacunar stroke are severe, a doctor can give you intravenous medication to break up the clot. Other medical treatments include a neurosurgeon's removal of the blockage or clot in the brain. Lacunar stroke is not a life-threatening condition. If caught early, it may not require surgery and recovery could take weeks or months. However, severe brain damage may require physical rehabilitation and may require a lifetime of care.

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Although most strokes are ischemic, there are several differences between these two types. The cerebral circulation is primarily made up of the arterial system, which forms the circle of Willis. Some of these branches feed the cerebrum's deep gray and white matter. A small infarct is caused when the arteries feeding these areas become blocked. Because of the small size of lacunar strokes, these strokes can vary in size. In fact, a recent study found that a small percentage of lacunar strokes are less than ten millimeters in size.

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The most common type of lacunar stroke involves the motor and sensory areas of the brain. Because these areas are affected by the stroke, they may not exhibit any cortical signs. Patients with a pure motor lacunar stroke usually suffer from unilateral weakness in one or more limbs, as well as dysarthria. The onset of symptoms will depend on the severity of the stroke, but typically occurs over minutes to hours.

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A large number of patients with lacunar stroke were included in the study. All were part of a longitudinal study of stroke mechanisms. The study excluded those who were incapable of consenting to the study, or who had a medical condition that would prevent follow-up assessment. It was also important to note that if the patients were not capable of consenting, MRI baseline examinations were not used to make a diagnosis of stroke. And patients with a severe kidney impairment were also excluded from the study.

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Risk factor profiles for patients with lacunes differ for different types. The risk of symptomatic and silent lacunes was related to internal carotid artery stenosis. Age and sex were also important, but they did not share risk factor profiles between these two groups. The risk of developing lacunes was significantly higher in those with severe internal carotid artery stenosis. Moreover, the occurrence of multiple lacunes was strongly related to a high maximum internal carotid artery stenosis.

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Age and number of lacunes were associated with a decreased WMH volume, but this association disappeared after adjusting for vascular risk factors, including age and number of lacunes. The study showed that RSSI volume predicted 1-year changes in WMH volume. However, it failed to predict the change in WMH volume among patients with old ischemic stroke. This suggests that lacunes may be a protective factor for ischemic stroke, although other risk factors like age and vascular status may be involved in the process.

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