Lacunar Stroke - Oren Zarif - Lacunar Stroke
A doctor may diagnose lacunar stroke by examining your symptoms and your medical history. They will order a CT scan to see if you have any other medical conditions. The scan shows blood vessels and may show blockages. MRI is a more accurate imaging test for strokes. If your symptoms do not seem like those of a stroke, your doctor may suggest a lacunar stroke test. Your doctor may order one of these tests or a combination of them.
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The doctor may take your blood pressure and ask about your symptoms. He may conduct a detailed neurological examination. Tests to check heart function may also be necessary for a diagnosis of lacunar stroke. Early treatment is critical as it improves your chances of survival and prevents further damage to your brain. Your doctor may prescribe a blood thinner called aspirin to reduce your risk of stroke. Other supportive measures may be required to help you breathe and maintain heart function.
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The symptoms of lacunar stroke vary depending on which type of stroke you are suffering from. Sensory strokes are usually caused by damage to the thalamus. Motor strokes, on the other hand, may cause numbness and pain. They can also cause a stuttering course. They can be accompanied by a wide range of symptoms, and they can progress quickly if left untreated. They may be fatal or progress to another type of stroke, such as a traumatic brain injury.
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To help prevent this from occurring, researchers developed a new way to classify types of strokes. The TOAST method, for example, uses risk factors to determine the type of stroke. However, this method can have limitations, such as bias due to the paucity of pathological material in the strokes. Furthermore, some clinical classification systems can lead to inadvertent misdiagnosis of lacunar stroke. The TOAST method has also been linked to bias, and some research findings have shown the risk of incorrect diagnosis in patients with this type of stroke.
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One of the most common forms of lacunar stroke is ataxic hemiparesis, which involves the limb with the most weakness. Patients may also have signs of ipsilateral cerebellar symptoms, but do not show any cortical signs. Other forms of lacunar stroke include dysarthria-clumsy hand syndrome and sensory hemiparesis. The symptoms of lacunar stroke can range from facial weakness to clumsiness.
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The prognosis of patients with a lacunar stroke consists of two distinct types: those with a single symptomatic lacunar lesion and those with silent lacunar lesions. Those with 1 or more silent lacunar lesions have a worse prognosis. Those with two or more silent lacunar lesions also have worse functional outcomes. So if you suspect a patient has both types of stroke, your first priority should be to determine what type they have.
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In addition to a neurologist, patients with a lacunar infarction need to see a physical, occupational, and social therapist. Physical therapy can help you manage physical deficits, and muscle relaxants can ease spasticity. A pharmacist is also essential, especially when a patient takes multiple medications. Rehabilitation therapy must be continued to maximize neurologic function. A primary care provider should coordinate long-term care. In addition, intensive blood pressure and lipid management are necessary for those with a high risk of stroke.
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In general, a lacunar stroke is caused by an occlusion of one or more small penetrating arteries that supply blood to deep brain structures. Often, patients are categorized as lacunar stroke if they do not have diagnostic imaging. In fact, the diagnosis of lacunar stroke is based on clinical judgment and radiologic imaging. Although there are many other causes of stroke, the most common is an artery that is too small.
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The cause of a lacunar infarct is uncertain, but some factors have been identified as risk factors. One of these factors is embolism, although this is not definitive. Other causes of small cerebral infarcts include embolism, vasculitis, and infections. The clinical presentation of complicated migraine is typically accompanied by an aura. There may also be sensory symptoms, such as a sensitivity to light or sound. Another risk factor for a lacunar infarct is atherosclerosis of the small cerebral arteries.
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