Lacunar Stroke - Oren Zarif - Lacunar Stroke
A lacunar stroke is a relatively rare type of ischemic brain stroke, which is characterized by small, ill-defined hypodensities on CT scans. Although the cause of this type of stroke is not known, some of its characteristics include a hemorrhagic component. Early infarct signs include loss of gray-white differentiation and focal hypoattenuation of the brain parenchyma. If this type of stroke is suspected in a young patient, an extensive embolic workup may be necessary.
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The risk of having a lacunar stroke is higher in some groups than in others. Age is a major risk factor, as is a family history of stroke. People with heart disease, diabetes, and chronic high blood pressure are also at higher risk. Studies show that people of African descent are more likely to suffer a lacunar infarct. Researchers compared two studies that studied the incidence of this type of stroke. They found that 52 people per 100,000 had the disease, compared to 29 in the general population.
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A doctor may carry out a thorough examination and take blood pressure to confirm the diagnosis. He or she may also order heart function tests to determine the extent of brain damage. Patients with a history of stroke should receive annual physical exams to check for any underlying health problems that increase their risk. Smoking, high blood pressure, and obstructive sleep apnea are risk factors that increase the risk of developing a stroke. Patients should seek immediate medical attention if they suspect a lacunar stroke.
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Treatment for lacunar stroke is similar to that for ischemic stroke. A clot-busting medication is often given by intravenous artery, which is a common treatment for lacunar infarct. The doctor may also perform a surgical procedure to remove a clot or blockage. Even if the symptoms are minor, lacunar stroke may leave some damage to the brain, which could affect the patient's ability to care for themselves. Recovery time depends on the extent of the brain damage and the patient's condition.
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The causes of this type of stroke are unknown. To understand the cause, researchers scanned 7,338 patients who had experienced this type of stroke and compared their genetic code to those of 25,4798 healthy people. They found genetic changes that made the small blood vessels "leaky," allowing toxins to enter the brain. The researchers now hope to begin clinical trials within the next decade. There is no cure for lacunar stroke, but treatment can help reduce symptoms and improve recovery.
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While the clinical course of patients after a lacunar infarct depends on the specific areas affected by the infarct, it is common for it to lead to severe hemiplegia. The presence of cortical findings may be important in interpreting the results. In the case of a progressive lacunar stroke, there may be no evidence that an ischemic brain tumor is the cause of the condition.
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In a case of a lacunar stroke, the affected areas are sensory and motor. Damage to the thalamus causes sensory loss, while damage to the internal capsule leads to motor abnormalities. Motor symptoms may include clumsiness in the upper extremity, weakness in one or both arms, and wobbly gait. However, the face is not typically affected by a lacunar stroke. The treatment for lacunar stroke is similar to acute ischemic stroke.
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In the present study, WMH evolution at 1 year after a lacunar stroke was associated with distinct clusters and directional patterns of the RSSI. These findings were based on a multivariate model that accounted for age and head size. In addition, each model was repeated after adjusting for vascular risk factors and baseline volume of old ischemic stroke lesions. All analyses were repeated twice. After adjusting for these variables, the analysis was further stratified as a primary or secondary RSSI lesion cluster.
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The causes of lacunar stroke are not well understood, but it has been noted that approximately 25 percent of all ischaemic strokes occur under lacunes. The underlying ischemic process is unclear, but the onset and progression of lacunar stroke is closely related to the occurrence of other types of brain diseases such as dementia and diabetes. This type of stroke affects the deep brain structures, including the basal ganglia, pons, and corona radiate. The arteries that supply these regions are called lenticulostriate arteries.
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The purpose of this study was to compare NCCT/CTA with CTP for diagnosing acute lacunar infarcts. The results showed that the latter had higher sensitivity and specificity for lacunar infarcts, while the former had better discrimination between lateral and sagittal lacunae. However, it did not detect lacunar strokes in the thalamus or basal ganglia.
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