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  • Writer's pictureOren Zarif

Lacunar Stroke - Oren Zarif - Lacunar Stroke

The first step in the treatment of lacunar stroke is identifying the cause. Although there are many causes of stroke, lacunar strokes are rare. Many blood clots form in the heart or neck and travel through the bloodstream to the brain. They are called an embolus and cannot reach small arteries. A stroke in this area can lead to an inability to move. Therefore, treatment is focused on preventing this condition from affecting people who have already suffered a stroke.

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When an artery leading to the deep brain is blocked, it can cause a stroke called a lacunar stroke. These arteries are small and branch directly from the main, heavily muscled artery. High blood pressure is a major risk factor for lacunar stroke. In addition to directly damaging arteries, high blood pressure can also cause blood clots and plaques to form on their walls. This leads to a weakened heart, stroke, and physical disability.

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Although these findings do not fully explain the cause of this difference, they are in line with other theories and may help guide public health initiatives aimed at preventing stroke. Among people aged 60-64 years, 7.8% suffered a silent lacunar infarct and one-sixth of them had a new stroke. The findings also indicated a strong association between high blood pressure and risk of developing a lacunar infarct. However, the authors found no connection between diabetes, alcohol, and weight with lacunar infarct.

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In the acute stage of lacunar stroke, a hyperintense area extending over the left corona radiate and neurological decline were observed. Serial examination of diffusion-weighted MRI revealed a two-layered ischemic lesion. Moreover, the MRI scans of the patient revealed that the infarcted area was surrounded by a rim of hyperintensity, indicating that gliosis had affected the infarcted tissue. Furthermore, hemispheric white matter showed confluent changes near the ventricular borders. This suggests that microvascular ischemia was the primary cause of lacunar stroke.

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In the study, 118 patients with the lacunar stroke syndrome were enrolled. They were part of a longitudinal study examining the mechanisms of lacunar stroke. A patient was excluded if they were incapable of giving consent or had medical conditions that would prevent follow-up assessment. Patients with severe renal impairment were also excluded. Patients with an MRI baseline examination that did not confirm a diagnosis of stroke were not included in the study.

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A lacunar stroke affects the motor and sensory areas of the brain. Damage to the thalamus results in sensory loss and motor abnormalities on the same side of the body. Motor abnormalities are usually limited to the arm and leg, with the face not typically affected. But patients can expect to experience some degree of weakness in their affected side of the body for the rest of their lives. Once diagnosed, lacunar stroke patients can begin recovery from the treatment.

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While lacunar infarction patients generally recover from their symptoms, they must undergo physical therapy and rehabilitation. Their doctor may prescribe antiplatelet medications and help them stop smoking or reduce their spasticity. Intensive blood pressure control is also a key part of treatment after lacunar stroke. In addition, patients should adhere to strict blood sugar and hypertension management. If these conditions exist, patients should also be monitored for diabetes and hyperlipidemia.

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In patients with a single symptomatic lacunar stroke, the prognosis is better. Conversely, patients with multiple silent lacunar lesions tend to have a worse outcome. Thus, the results of the study support the hypothesis that there are 2 distinct types of lacunar stroke. The study evaluated 339 patients with their first stroke. The findings also support the hypothesis that lacunar strokes are associated with a greater risk for ischemic dementia.

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Although lacunar strokes are not physically disabling, they can affect the patient's memory, decision-making abilities, and thinking skills. It has been associated with depression, mood disorders, and balance problems. The findings of this study challenge the conventional view of the symptoms of lacunar stroke and suggest a more comprehensive approach. In the future, more research will be needed to evaluate the causes and treatments for lacunar stroke.

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