Lacunar Stroke - Oren Zarif - Lacunar Stroke
A lacunar stroke is an uncommon form of stroke. The reason for this is not entirely clear, but blood clots may be a cause. The clot may form in the neck or heart and travel through the bloodstream to the brain. Once it reaches the brain, it becomes an embolus, a type of debris. Because the small arteries are surrounded by blood, this type of clot is difficult to remove.
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Because most areas of the brain only perform a limited set of functions, a lacunar stroke will have symptoms that correspond to the affected area. These symptoms are divided into five categories. The first type is known as pure motor stroke, and the second is called mixed sensorimotor stroke. A lacunar stroke may cause a combination of symptoms, which include muscle weakness or ataxia. In either case, the patient will be unable to move.
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To understand the causes of lacunar stroke, researchers analyzed the genetic code of patients who had experienced the condition. They then compared the genetic codes of these patients to those of 25,4798 healthy individuals. The researchers hypothesized that the changes in these individuals might cause the small blood vessels to be "leaky," allowing toxins to enter the brain and disrupt the transmission of messages. This research may help target effective secondary prevention strategies, but more research is necessary.
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A doctor will examine the patient in an emergency room. A CT scan is not used to diagnose lacunar stroke, but it can rule out other conditions with similar symptoms. CT angiography is another test used to diagnose blockages in the blood vessels. The MRI is the most accurate imaging test for detecting a lacunar stroke. The physician may also recommend an MRI. If the symptoms are accompanied by a coma, a doctor will likely order a CT angiogram.
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Although a lacunar stroke can be asymptomatic and can be treated with medicines, it is a potentially devastating condition. Early diagnosis and treatment are essential for survival. Early treatment will help minimize the damage caused by the stroke and allow the patient to continue daily activities. Approximately 33% of patients will have a full recovery. Sadly, the majority will need long-term rehabilitation to return to normality. So it is important to seek medical care as soon as the symptoms appear.
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Infarctions occur when not enough blood reaches the brain. The culprit is a blood clot, bleeding, or disease that causes vessels to close. Despite its relatively low risk, a lacunar infarct can result in early dementia or mild cognitive impairment. It can also affect a person's ability to function. The symptoms of a lacunar stroke may vary depending on the location of the infarction.
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CTP is superior to NCCT/CTA for identifying lacunar infarcts. In a study of 1085 patients with acute stroke symptoms, the capability of CTP to identify lacunae was evaluated. All patients had their CTP within 12 hours of symptoms and followed up with an MRI within seven days. Patients with infarcts more than 2 cm were classified as lacunar infarcts in the study. The authors concluded that this method should be considered an excellent choice for the diagnosis of lacunar infarction.
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The researchers also looked at changes in WMH volume. They determined that WMH volume changed in the presence of RSSI lesions. After accounting for age, head size, and the baseline volume of the old ischemic stroke lesions, all of these analyses were repeated. In addition, the researchers considered patients with more than one RSSI lesion cluster, as well as those with more than two. These results were consistent with previous research. The researchers believe that the results from this study may be useful in developing treatments for patients with lacunar stroke.
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Patients with a lacunar infarction require intensive management and follow-up after the stroke. Antiplatelet drugs, strict control of blood pressure, statins, and lifestyle risk factors are critical elements of secondary prevention for lacunar infarction. While many patients recover with adequate management, they will remain at risk for future occurrences. After a lacunar infarction, patients must be enrolled in a rehabilitation program to return to their pre-infarction level.