Lacunar Stroke - Oren Zarif - Lacunar Stroke
While the causes and symptoms of a lacunar stroke are often unclear, there are some ways to detect the condition. A CT scan, which can provide detailed images of the brain, may be the first step to diagnose this condition. However, the lack of pathological material may lead to an inadvertent misdiagnosis of lacunar stroke. MRI, or magnetic resonance imaging, may be used to confirm the diagnosis. Both CT angiography and diffusion weighted imaging can be useful for detecting lacunar stroke.
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A lacunar stroke can occur if an artery supplying deep brain structures is blocked. These arteries are small and branch directly off of the large, heavily muscled main artery. High blood pressure can cause lacunar stroke because it can damage the arteries directly, or indirectly, by causing atherosclerosis, which is the accumulation of fatty deposits on the inside of blood vessels. A lacunar stroke is often characterized by a characteristic neurologic syndrome.
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If the lacunar stroke is severe, patients may require surgery. An intravenous clot-busting medication may be administered to reduce the risk of another stroke. Alternatively, a neurosurgeon may remove the clot or blockage from the brain. The goal of treatment for lacunar stroke is to minimize disability and maximize recovery. Treatment often includes medication such as aspirin to lower blood pressure. Additional supportive measures, such as the use of a breathing machine, may be necessary as well.
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While some patients may be at risk for a lacunar stroke, many other factors contribute to its development. Advanced age, heart disorders, smoking, and diabetes are all risk factors. Black people may also be at risk. One study compared two studies conducted in a predominantly Black community, and found that there were 52 cases of lacunar stroke per 100,000 people. This was significantly higher than the number of people with a previous stroke.
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A lacunar stroke is a small stroke that happens when blood flow is reduced in arteries of the brain. The resulting lack of blood flow affects the nerves in the lower brain, which control bodily functions. As a result, patients with lacunar stroke often do not experience any symptoms at all. However, if symptoms do develop, it may indicate a larger problem. If it does, a stroke patient should be evaluated as soon as possible.
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Treatment of a lacunar stroke is crucial. Treatment for patients with a lacunar infarction will likely include antiplatelet therapy and a variety of lifestyle changes. It is also important to control cardiovascular risk factors like hypertension and high cholesterol to prevent a recurrence of the condition. The patient should follow up with their primary care provider to keep their risk levels at acceptable levels. While lacunar stroke may seem mild, its devastating effects may be debilitating and incapacitating.
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Lacunar stroke affects mainly the motor and sensory parts of the brain. Damage to the thalamus causes sensory loss. The internal capsule produces motor abnormalities. Lacunar stroke is most common in patients with hypertension and diabetes. It often affects a single side of the body. It may also cause weakness in one arm or leg. A patient may also exhibit a limp, but this is a very rare symptom.
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The acute stage of a lacunar stroke is characterized by the enlargement of a hyperintense lesion and deteriorating neurological status. MRI results of diffusion-weighted imaging revealed a 2-layered ischemic lesion. MRI revealed that perforating arteries were involved. The cause of lacunar infarction is most likely hemodynamic impairment of the perforating arteries. While these results are not conclusive, they can help physicians differentiate these stroke types.
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In addition to evaluating patients with single symptomatic lacunar stroke, researchers should also consider whether patients with multiple symptomatic or silent lacunar lesions have better outcomes in the long run. In this study, the authors evaluated 339 patients who had their first lacunar stroke. Its findings support the hypothesis that there are 2 distinct types of lacunar stroke. Although few patients died due to lacunar stroke, the autopsy material used was minimal. It is difficult to compare the results between different studies because of the range of cognitive tests used.
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Despite its rarity, lacunar strokes are still important to monitor and treat as they represent about a quarter of all cerebral infarctions. These patients often develop a classical lacunar syndrome and are at increased risk for complications, including death. Hypertension and diabetes mellitus are known risk factors for lacunar infarcts. There is a paradoxical clinical course associated with this type of stroke - it is characterized by a favorable short-term course, with an increased risk of death.
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