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  • Writer's pictureOren Zarif

What is a Lacunar Infarct? - Oren Zarif - Lacunar Infarct

If you are wondering what a Lacunar Infarct is, you are not alone. Over 3600 people were enrolled in the Cardiovascular Health Study, a study of the elderly. Researchers have been comparing clinical correlates of MRI findings among these groups for over four decades. This study also included patients who were not aware that they were having a stroke. In the study, the lacunes were defined as subcortical areas consistent with infarcts, which can range from 3 to 20 millimeters in size.

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Many studies have been conducted to determine the mechanism of lacunar stroke. Although the underlying cause is still not known, some researchers believe that the plaques are emboli from larger arteries and/or the heart. Some studies have concluded that the lacunar hypothesis is not fully supported by evidence, and some of these studies only dealt with symptomatic patients. In contrast, the literature on the origin of lacunar strokes suggests that emboli from the arteries occlude the afferent artery.

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Although the causes of lacunar infarct are not yet fully understood, there is a high likelihood of developing one. People with a family history of stroke may have an increased risk of developing one. Regular annual physical exams can screen for underlying health conditions that can raise the risk of stroke, including high cholesterol and obstructive sleep apnea. Whatever the cause of the lacunar infarct, emergency treatment is necessary.

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Age is a risk factor for lacunar stroke. Age and gender are also factors. People with chronic high blood pressure, diabetes, and atrial fibrillation are at higher risk. Furthermore, Black people have been found to have a higher risk of lacunar infarct. Researchers examined two studies that occurred in mostly Black communities. While the incidence was 29 per 100,000 people, the researchers concluded that it was more common in Black people than among white people.

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The prognosis for a lacunar infarct depends on the speed at which the patient is diagnosed. The longer it takes to remove the blockage, the greater the damage to brain cells. The faster the treatment is applied, the better the prognosis is. In general, a lacunar infarct is more likely to lead to further strokes, dementia, or death from cardiovascular causes.

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A study of NCCT/CTA has found that CTP is a superior tool for detecting lacunar infarcts. The researchers evaluated the sensitivity and specificity of CTP in 1085 patients who had experienced onset of stroke symptoms within twelve hours and then underwent MRI within seven days. Infarcts with a width of 2 cm or more were recorded. The patients with the greatest risk of a lacunar infarct had a higher NIHSS score.

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The symptoms of lacunar infarct depend on the affected part of the brain. Different areas of the brain control different aspects of the body. In the left hemisphere, for example, control motor functions and sensation while the right hemisphere controls sensation on the right side. A lesion on one side of the brain will affect the opposite side. This is why lacunes are not immediately visible on an MRI.

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When the small penetrating arteries that supply blood to the deep structures of the brain are occluded, the resulting infarct is referred to as a lacunar cerebral infarct. The symptoms of lacunar cerebral infarct may be similar to other ischemic strokes without radiologic imaging. However, the diagnostic criteria for lacunar stroke differs from those for other types of ischemic stroke.

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The prevalence of the four lacunes and the subgroups were highly correlated with age and vascular risk factors. However, after accounting for age, number of lacunes, and vascular risk factors, the associations disappeared. However, age and sex are the strongest predictors of all four subgroups of lacunes. Although the prevalence of these conditions was higher in women than in men, the proportion of patients with the condition was similar between men and women in the general population.

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After a Lacunar Infarct, patients require long-term care management. Rehabilitation therapy is critical to maximize neurologic function. Physicians must coordinate rehabilitation therapy, including physical therapy and use of muscle relaxants. Primary care providers are responsible for long-term care coordination. Intensive treatment for hypertension and lipids is also required to reduce risk of stroke. Strict control of blood sugar levels is also crucial.

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Patients who have experienced a single symptomatic Lacunar Infarct have a better prognosis over time than those with multiple, silent Lacunar Infarcts. The findings support the concept of two distinct types of Lacunar Infarct. The study looked at 339 patients with their first lacunar stroke. It should also be considered a primary diagnosis of stroke if you suspect monoparesis.

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