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  • Writer's pictureOren Zarif

Lacunar Stroke - Oren Zarif - Lacunar Stroke

While it is not entirely clear what causes lacunar stroke, it is considered to be an ischaemic stroke and results in cognitive decline. These strokes are similar to other types of ischaemic strokes, such as WMLs, and their underlying mechanism may be the same. Because of this, lacunar stroke has been lumped in with other types of stroke, but may need a different acute treatment and prevention than other types.

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There are several risk factors associated with lacunar stroke. Smoking, diabetes, and high blood pressure are known risk factors. Black people may also be at higher risk for this type of stroke. A recent review of two studies conducted in predominantly Black communities found that this type of stroke occurred 52 times in every 100,000 people. The other study found that the incidence of lacunar stroke was only 29 per 100,000 people. For these reasons, experts are eager to find a cure for this deadly stroke.

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If your doctor suspects a lacunar stroke, they will evaluate your symptoms, conduct a detailed neurological exam, and order tests to determine if there is a blockage or clot. A neurosurgeon may also remove the blockage or clot. Treatment for lacunar stroke is important because it increases the chances of survival and prevents further damage to the brain. A doctor may also prescribe aspirin to reduce the risk of stroke. Other supportive measures may be needed to help with breathing and heart functions.

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Symptoms of a lacunar stroke vary, and typically occur in minutes to hours. These symptoms often progress in a similar fashion to that of an ischemic stroke. One symptom is complete loss of motor and sensory function in a single side. A similar condition can result in asymmetrical muscle weakness in one side of the body. A patient with a pure motor lacunar stroke may have clumsiness or facial weakness in one arm.

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There is no consensus on what causes a lacunar stroke, but one thing is certain: these strokes do not cause any symptoms in the cortex. The brain's deep structures receive blood flow through special arteries. This is different from other strokes, which affect the outer part of the brain. The artery that supplies the deep structures is different from those that supply the cortex. However, lacunar stroke is still very serious.

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Although the clinical signs and symptoms of lacunar stroke may not be obvious, they are common enough to affect patients and are often overlooked. While patients do not usually display any symptoms of the disease, many of them will experience progressive neurologic deficits. The resulting death of neurons and tissue in the brain may interfere with bodily functions and result in irreversible cognitive decline. The study authors believe this is a common cause of lacunar stroke.

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While patients who experience a single symptomatic lacunar stroke have a better prognosis than those who suffer from multiple silent lesions. This study also supports the notion that there are two distinct types of lacunar stroke. It evaluated 339 patients who had their first lacunar stroke. A number of them suffered a multiple stroke, which can lead to a lifelong disability. The authors suggest that the difference between the two types of lacunar stroke is due to the fact that the latter is more likely to be associated with multiple, smaller, and symptomless strokes.

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The risk factors of lacunar infarctions are similar to those of other forms of ischemic stroke. The most common risk factors include hypertension and diabetes mellitus. However, there are varying degrees of evidence for their occurrence. Nonetheless, the risk of death is significantly increased and the clinical course is paradoxical. A study published in Barcelona found that hypertension and diabetes mellitus increase the risk of lacunar infarcts.

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Another study found that CTP had better sensitivity for detecting lacunar infarcts than NCCT/CTA in patients with acute stroke symptoms. The researchers examined 1085 CTP examinations in patients with acute stroke symptoms and MRI within 7 days of the incident. They documented if infarcts measured two centimeters or larger were present. They also analyzed patients with NIHSS scores to determine whether they had suffered a lacunar stroke.

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Patients who survive a lacunar infarction generally exhibit significant improvement in their neurologic functions. They may still require rehabilitation and follow-up care after discharge from the hospital. Antiplatelet drugs and careful control of blood pressure are critical in secondary prevention after lacunar infarction. Lifestyle risk factors such as smoking and excessive alcohol consumption must be controlled strictly. Once the patient is discharged, rehabilitation therapy should continue to maximize neurologic function.

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