Lacunar Stroke - Oren Zarif - Lacunar
A lacunar stroke affects the motor and sensory areas of the brain. The damage to the internal capsule and thalamus causes sensory loss and motor abnormalities. This type of stroke usually affects the arm and leg on the same side of the body, although the face is usually unaffected. In some patients, there may be a lack of sensation in one or both arms and legs. If you have a suspected lacunar stroke, the initial evaluation will include a CT or MRI of the brain.
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The underlying cause of lacunar stroke is still unclear. Several risk factors have been identified, including advanced age, hypertension, smoking, diabetes mellitus, and alcohol consumption. In addition, the presence of prior strokes increases the risk. Various types of pathology can cause a lacunar stroke, including carotid artery pathology and microemboli from the heart. Although most patients recover from lacunar strokes, a small percentage can suffer from subcortical dementia or develop white matter disease.
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Although the cause of lacunar stroke remains unknown, emboli from other arteries can lead to these lesions. These emboli may have originated in a heart-related blood vessel, but the prevalence is still low. Further research is needed to determine whether lacunes can develop as a result of other causes of ischemic stroke. Even if there is no definite cause for lacunar stroke, they can be an important part of secondary prevention regimens.
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Patients suffering from a lacunar stroke will be evaluated by a physician in the emergency room. A CT scan is not used to diagnose lacunar stroke, but it is a useful imaging tool for excluding other causes of similar symptoms. An MRI, on the other hand, is considered the most accurate tool for diagnosing lacunar stroke. And the doctor will use it to check for underlying atherosclerosis or blockages.
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Although a TIA is a rare type of stroke, if you experience any of the symptoms, you should consider the possibility of a stroke, because it can lead to permanent disability. Treatment options for lacunar stroke include medicines that improve circulation. If you experience any of these symptoms, seek medical care immediately. It may be possible to reduce the effects of the stroke and return to a normal lifestyle. Even if you don't develop a stroke, a lacunar stroke can be devastating to your health and may result in lifelong disabilities.
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In the CHS, patients with lacunar syndrome are more likely to be elderly, compared to younger patients. In addition to ischemic infarctions, lacunes can be caused by other causes of stroke, including a ruptured blood vessel. In some cases, the condition may not present symptoms at all, making it difficult to diagnose. Further research is needed to determine whether lacunes are an early indication of stroke. The findings from the CHS study are promising, but further studies are needed to confirm these results.
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Studies indicate that more than a quarter of all ischaemic strokes are lacunar. The causes of lacunar stroke vary from patient to patient, but they are generally attributed to occlusive disease, which occurs due to chronic hypertension, diabetes, and other genetic factors. The occlusion of these penetrating arteries results in medial thickening and a small infarct in the region supplied by the small vessel. The limited collateral circulation causes a large infarct, and the affected area may coalesce into a lake-like infarct.
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Patients with symptoms of lacunar stroke should be evaluated immediately. The doctors may prescribe muscle relaxants and anticonvulsants. Some patients may also receive botox and baclofen, which are medications that reduce the risk of another stroke. Patients should also be on strict blood glucose control and outpatient rehabilitation therapy until neurologic function returns to baseline prior to the infarction. These treatments are not a cure for the disease, but are a necessary part of recovery.
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The first step in treating a lacunar stroke is to identify the artery that is blocking the blood flow to the deep structures of the brain. The small arteries in the brain's lacuna branch directly off the main artery. This artery is heavily muscled, but it has been estimated that high blood pressure is the most common cause of lacunar strokes. High blood pressure can directly damage the arteries and cause atherosclerosis, which causes the buildup of fatty deposits on the inner walls of the arteries.
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Another important step in the management of patients with lacunar infarcts is to determine the risk factors that are associated with the condition. Some risk factors that may increase the risk of developing lacunar infarcts are hyperhomocysteinemia, high blood pressure, and baseline WMH volume. Patients with these conditions should be carefully monitored for symptoms and signs, as these may signal a stroke. If you have an artery disease, you should consult a cardiologist.
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