Lacunar Stroke - Symptoms and Treatments - Oren Zarif - Lacunar
A lacunar stroke occurs when a blood clot forms in the neck or heart and travels through the bloodstream to the brain. This type of stroke is also known as an embolus, and while patients recovering from lacunar stroke are usually cured, the disease can result in significant damage to white matter and lead to subcortical dementia. Listed below are symptoms and treatments of lacunar stroke. Getting a proper diagnosis is essential to avoid complications and improve patient outcome.
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During the evaluation process, your doctor will ask you about your medical history and perform a physical examination to determine whether you're having a lacunar stroke. A CT scan is not recommended for the diagnosis of lacunar stroke, since it is too small to show up clearly on a CT scan. MRI, however, is considered more accurate in the diagnosis of lacunar stroke. This procedure is performed to look for blood vessel blockages in the brain.
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A lacunar stroke affects both the motor and sensory areas of the brain. Because of the damage to the internal capsule, patients experience sensory loss or motor abnormalities on the same side of the body. Motor abnormalities include weakness or wobbliness in the arm or leg. This type of stroke is rare in the face. Although it can be life-threatening, treatment is similar to that of acute ischemic stroke. In addition to being difficult to recognize, lacunar stroke can result in permanent disability.
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The exact mechanism of lacunes has not been determined. While some cases are caused by emboli from the heart or larger arteries, there is no definitive evidence of their cause. However, epidemiological and clinical reasons for separate lacunar syndromes are clear. The authors recommend that researchers study patients with 2 or more lacunar strokes to better understand the disease. The goal of their study is to identify the risk factors and treat patients accordingly.
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If the patient has a large amount of atherosclerosis or hypertension, it is possible for them to develop a lacunar stroke. This type of stroke affects deep parts of the brain. If left untreated, it can cause irreversible damage to the brain. Because the arteries are narrowed, high blood pressure directly damages these small arteries and causes fatty deposits on their walls. As a result, the brain is left without oxygen and cells begin to die.
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The authors conclude that lacunes are commonly present in older adults and may differ from other types of stroke. The CHS study examined 3660 participants and found that eighty-four (1131) had lacunes while only four had an ischemic infarct. Interestingly, 841 of the participants with lacunes did not report a history of stroke. While these findings are encouraging, further studies are needed to confirm the conclusions of the researchers.
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While it is possible that patients with lacunar stroke do die, it is not common. Deaths due to lacunar stroke occur often years after the stroke, and autopsy material is often scant. Because these patients have small cerebral vessels, studies have mostly relied on clinical diagnosis. However, if a patient does develop a lacunar stroke, there are also a number of risk factors that are associated with the development of this condition.
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Early treatment of lacunar stroke is crucial. Treatment must occur within three hours of noticing the first symptoms. Treatment can help reduce the symptoms and speed recovery. If detected in the early stages, the recovery rate of lacunar stroke is much higher than that of other types of stroke. Ninety percent of patients recover substantially within three months. And if left untreated, it can be a lifelong disability. This condition requires intensive rehabilitation and may even lead to a permanent disability.
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Despite its atypical presentation, lacunar strokes are not rare. Around one fourth of all ischaemic strokes are lacunar. During the mid-19th century, Dr. Miller Fisher first described arterial pathology under lacunes. It is the result of chronic hypertension, diabetes, and genetic factors. The affected vessels develop medial thickening, causing occlusion of penetrating arteries. The resulting infarcts are typically small, and are characterized by a lack of collateral circulation. The affected areas coalesce in a lake-like shape.
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After a lacunar ischemic event, patients must be managed by a neurologist, physical therapist, occupational therapist, and social therapist. Initially, physical therapy is critical to minimize physical deficits, and patients may need muscle relaxants to manage spasticity. Pharmacists are also critical, as they check for potential drug interactions. Outpatient rehabilitation therapy must continue until neurologic function returns to pre-infarction levels.