Lacunar Stroke - Oren Zarif - Lacunar

A lacunar stroke is a complication of heart disease that results from a blockage of an artery that supplies blood to the brain's deep structures. The arteries that supply these parts of the brain are relatively small, branching directly from a large artery, which is heavily muscled and high-pressure. Lacunar strokes can occur due to high blood pressure, which causes direct damage to arteries and the formation of fatty deposits on the walls of blood vessels.

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If a lacunar stroke occurs in a patient who has a history of untreated high blood pressure, the stroke symptoms may vary, depending on which part of the brain is affected. Different areas of the brain control different functions, including vision, sensation, speech, and balance. If the stroke occurs in multiple areas of the brain, patients may experience emotional behavior, dementia, or both. While there is currently no cure for lacunar stroke, medications and neurosurgical interventions can make a patient's symptoms better.

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While the risk of TIA is lower than that of a full-blown stroke, there is no substitute for proper medical care. Treatment must occur within three hours of the onset of symptoms. If treatment is initiated immediately, most patients recover within days or hours. A majority of patients recover significantly within three months. Even if the symptoms do not disappear after the first few weeks, they may have permanent disabilities or require physical rehabilitation. For these reasons, treatment is critical for lacunar stroke patients.

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In patients with a history of stroke, advanced age and the presence of a vascular risk factor, such as smoking, may increase the risk of a lacunar infarct. In addition, those with diabetes mellitus, high cholesterol, and a history of previous strokes may be at increased risk for lacunar infarcts. A diagnosis of a lacunar stroke requires matching the patient's clinical presentation with a small noncortical infarct. In the interim, treatment for acute ischemic stroke should include the following:

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MRI is the most accurate imaging modality for diagnosing lacunar infarction. It is particularly useful in differentiating between acute and chronic infarctions. MRI can distinguish lacunes from a large infarction because the lacunes appear as focal areas of decreased signal intensity on T1 and T2-weighted images. Chronic lesions are usually isointense to CSF. There are several causes of lacunes.

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In the Barcelona stroke registry, 146 patients with a lacunar infarct were included. In addition to spontaneous subdural haematoma, the disease has been associated with cardiac events, ischemic stroke, and cardiovascular diseases. A study of lacunar infarctions in this population compared the clinical characteristics of 146 patients with a history of cardiac events. It also found a link between the two types of infarctions.

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Acute diffusion-weighted MRI altered the final diagnosis in 40% of cases. However, it is important to note that most false positive cases of lacunar stroke were due to a large artery or cardiogenic embolic stroke. Nevertheless, this study is based on a clinical series of 146 patients, which supports the lacunar hypothesis that lacunar infarction is the most common cause of stroke. It also shows that lacunar infarctions are common, but they are not necessarily the same.

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A lacunar stroke occurs in one of the brain's four areas-the motor and sensory--as they are correlated to the side of the body affected by the stroke. A lacunar stroke results in loss of sensory function in the thalamus, which are responsible for voluntary movements, and motor abnormalities that cause weakness in the arm or leg. The face and other areas are rarely affected. In 45% of cases, the patient cannot move, despite the presence of other symptoms.

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The incidence of lacunar infarcts is increasing. Compared with other strokes, a high prevalence of vascular risk factors is found in patients with lacunar infarcts. Among these risk factors are hyperhomocysteinemia, hypertension, and baseline WMH volume. While there are many ways to prevent this condition, the only surefire way to prevent it is to avoid hyperhomocysteinemia and high blood pressure.

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Although there are some medications available to prevent stroke, they may not be effective in preventing a lacunar stroke. Moreover, they carry a higher risk of gastrointestinal bleeding. For this reason, patients suffering from lacunar strokes may need a combination of treatments that focus on preventing risk factors and improving daily activities. However, 33% of people who have suffered a lacunar stroke recover fully, but most suffer from a long-term disability.