Lacunar Stroke - Oren Zarif - Lacunar
The first step in treating a lacunar stroke is determining whether a blood clot is present. Although some lacunes are associated with a blood clot, the proportion is less than other ischemic strokes. Lacunar strokes are not always life-threatening and, therefore, may go undetected for days or weeks. Because lacunar strokes usually recover on their own, treatment focuses on removing the blood clot.
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Researchers from the University of Cambridge are seeking to identify the genetic causes of lacunar stroke. This research will use DNA from 5,000 people who have suffered a lacunar stroke to search for genes that may increase their risk. If a gene is linked to an increased risk for the disease, researchers hope to understand how the condition works and which medications might be effective. In the meantime, more research is needed to identify a cure for lacunar stroke.
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Patients with a single lacune on MRI should be monitored closely. One-third of these patients have an underlying medical condition that may be associated with the condition. MRI imaging of the brain is the most reliable way to detect the presence of a lacunar stroke. If there are no signs of other illnesses, it is important to rule out an underlying condition, such as atherosclerosis. Moreover, patients should have regular medical checkups to detect any potential stroke risk factors.
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Another type of lacunar stroke involves damage to the motor and sensory areas of the brain. The ischemia in the thalamus causes sensory loss and motor abnormalities on the same side of the body. Individuals with these strokes may experience wobbliness and a lack of coordination in one arm or leg. Patients with this condition do not typically experience facial weakness. Acute treatment of a lacunar stroke is similar to the treatment of an acute ischemic stroke.
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Patients with the lacunar type of stroke were included in a large longitudinal study to determine the underlying causes of this disease. They were excluded if they lacked the capacity to consent to the study, or if they had any other medical condition that made follow-up assessment impossible. Patients who had a cortical acute stroke were also excluded. And patients who had a prior stroke diagnosis or a history of ischemia were excluded.
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People who have a family history of stroke should seek medical treatment for a lacunar infarct as soon as they experience any of the symptoms. If they do, medical treatment may be effective and reduce the severity of their symptoms. The risks associated with lacunar stroke are very high, but treatment is possible. Symptoms of a lacunar infarct can last weeks or months. If left untreated, it can lead to permanent disability.
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Other risk factors may be associated with MRI-defined lacunes. These lesions may result in artery-to-artery emboli and affect hemodynamics. When age and sex were adjusted for risk, internal carotid artery stenosis and maximum stenosis were associated with a higher risk of lacunes. This finding requires further investigation. And it is also important to note that MRI-defined lacunes are common in older adults who deny a history of TIA.
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Many people who have a history of a lacunar stroke may benefit from taking antiplatelet drugs daily. These medications reduce the risk of a stroke by inhibiting the formation of blood clots. However, they are also associated with gastrointestinal bleeding. And a combination of these drugs may not be necessary. Even if it reduces the risk of lacunar stroke, the risks are higher than with the single agent.
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Treatment for patients who have experienced a lacunar stroke may include medications to manage their risk factors and therapy up to six times per day to improve their ability to carry out daily activities. Approximately 33% of people with lacunar stroke recover fully, but most suffer long-term disability. This is why prevention is critical. The best way to prevent a lacunar stroke is to improve your health and your quality of life. And you can do it by following these guidelines.
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Although age and sex are known to affect the risk of a lacune, their impact on cognition is still unknown. While some of these factors increase with a minor stroke, others decrease or regress. Improvements in the predictive power of a lacunar disease could help doctors to target treatments for patients with mild to moderate strokes. They can also be used in the early stages of a stroke. In the future, these findings could help guide treatment of patients with any type of stroke.
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