Causes of Lacunar Infarcts - Oren Zarif - Lacunar Infarct
The causes of lacunar infarcts are unclear, but some studies have shown that it can be caused by emboli from the larger arteries and the heart. While studies of the causes of other types of stroke are not conclusive, lacunar infarcts are considered cryptogenic if they do not occur as a result of heart disease. Although studies are still needed to understand the causes of lacunar infarcts, the most important thing to do is to consult your doctor as soon as possible.
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The MRI results of subjects with silent and symptomatic lacunes are highly variable. MRI findings can reveal a lacunar infarct in only 35% of patients. Therefore, a significant proportion of patients with silent lacunes may not have a lacunar infarct, and consequently not have any symptoms. Furthermore, they may have no history of stroke at all. However, if they do, they may have an increased risk of stroke.
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Treatment of lacunar infarct is similar to that of ischemic stroke. Treatment includes medications to break up blood clots, or surgery to remove the blood clots. After undergoing these procedures, patients are usually prescribed blood-thinning medications. The recovery time depends on how severe the stroke was and how much brain damage was done. However, if the stroke is severe, the patient may require a neurological intervention.
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In a retrospective study of patients with deep white matter infarct, only 38 of these patients were new cases of lacunar infarcts. The risk ratios were augmented after adjusting for age and sex and baseline white matter hyperintensity volume. Moreover, the risk ratios increased after adjusting for hypertension and antihypertensive drugs. The results of the study indicate that the risk of lacunar infarcts in these areas is significantly increased in people with hypertension or with previous history of stroke.
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Other causes of lacunar infarct include atherosclerotic narrowing of the extracranial carotid artery. Patients with severe carotid stenosis have a higher risk of stroke and may undergo carotid artery intervention. However, embolic workup has low yield in lacunar infarcts, and a CT scan may be required when the patient does not have any other underlying medical problems.
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The risk of new lacunar infarcts in basal ganglia differed among patients with and without a history of cerebrovascular disease. Patients with new lacunar infarcts were more likely to have hyperhomocysteinemia, hypertension, and a lower WMH volume than those without the condition. Although these factors were associated with a higher risk of new limb infarcts, these risk factors were generally not significantly increased in those patients with new infarcts.
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Although these strokes can be difficult to diagnose, these arteries can become blocked by plaques and other plaques. If this happens, the brain cells will die within minutes. Patients with multiple lacunar infarcts can suffer significant cognitive and physical disability. For this reason, it is imperative to seek medical attention immediately. The symptoms of lacunar infarct can vary according to the location of the infarct.
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The causes of lacunar infarct are still largely unknown. However, they are common hallmarks of cerebral small vessel disease. While they can be silent or cause clinical symptoms, their location is important for their etiology. Lacunar infarcts in deep white matter are often clinically silent. Infection of small penetrating arteries may cause a stroke. In addition to ischemic stroke, the presence of lacunar infarcts in this part of the brain can be a sign of arteriolosclerosis or endots in the deep white matter.
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The symptoms of lacunar infarct depend on which region of the brain is damaged. Because different parts of the brain control different aspects of the body, a lesion in one part of the brain can affect the opposite side of the body. A patient may experience numbness on one side of the body and tingling, pain, and unpleasant sensations on the other. A stroke in either hemisphere can cause permanent or temporary impairment of the affected side.
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All 4 subgroups were associated with different risk factors. The strongest associations were found for age, sex, and the number of pack-years smoked. Furthermore, having more than 50% stenosis of the internal carotid artery was also associated with having multiple lacunes. The underlying mechanisms for these associations are not clear. In a recent study, researchers found that the risk factors for developing multiple lacunes varied by subtype.
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The treatment of lacunar infarctions requires an interprofessional team. Several specialists will be involved in the patient's treatment, including a neurologist, a physical therapist, and an occupational therapist. Physical therapy may be used to manage physical deficits and muscle relaxants to prevent spasticity. Pharmacists are crucial in patients taking multiple medications, as they can check for drug interactions. Rehabilitation therapy must continue after lacunar infarct, including physical, occupational, and social therapies. Patients need to be followed up to ensure that they are regaining neurologic function. In addition, the primary care provider is responsible for long-term care coordination. Some risk factors for stroke include intensive antihypertensive therapy, lipid management, and strict control of blood glucose.
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