Lacunar Stroke - Oren Zarif - Lacunar Stroke
Lacunar stroke is a relatively small type of ischemic stroke. It is distinguished from other types of stroke by the presence of ill-defined hypodensities on a CT scan. A CT angiogram can identify blockages and atherosclerosis. An MRI can also be used to diagnose this type of stroke. Although not as sensitive as CT imaging, MRIs are more effective in identifying lacunar strokes than CT angiograms.
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A retrospective analysis of imaging and clinical data from patients suffering from acute stroke revealed that the incidence of lacunar infarcts was lower than in cortical infarctions. However, this approach may bias research by using risk factors and ignoring patients with atypical strokes. Inadequate pathological material may also result in the misdiagnosis of lacunar stroke. Further, the use of a standard clinical classification system could confound studies that use different definitions of stroke.
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Symptoms of a lacunar stroke will vary, depending on the area of the brain that is affected by the infarct. Depending on the specific area affected, these symptoms may include difficulty with sensation, speech, or balance, among others. The likelihood of a lacunar stroke is higher in people with a history of heart disease or diabetes. A recent review of studies found that people with chronic high blood pressure had a higher risk of developing a lacunar stroke. The researchers noted that people with chronic high blood pressure had 52 per 100,000 people.
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A lacunar stroke may affect one or both of the brain's hemispheres. Damage in the thalamus or internal capsule causes motor abnormalities in one or both areas. Because most areas of the brain perform a limited range of functions, a lacunar stroke can lead to a loss of movement in one or both of these areas. The symptoms of a lacunar stroke are typically symptomatic over a period of minutes or hours, and may progress in a similar manner as a stuttering course.
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Treatment of a lacunar stroke should include medications to restore circulation. Patients may be given intravenous clot-busting drugs to reduce the symptoms of the stroke. Sometimes a neurosurgeon will perform surgery to remove the clot or blockage. Although the symptoms of a lacunar stroke can last for weeks or even months, they can be reduced or gone completely by using medicines that restore circulation. People with severe brain injuries may need physical rehabilitation to regain their normal function. They may even need to undergo a permanent disability if they do not recover quickly.
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Although lacunar stroke is not commonly caused by blood clots, they are still a serious condition. Blood clots can form in the heart or neck, travel through the bloodstream, and ultimately affect the brain. Unlike other strokes, however, the clots cannot reach the small arteries in the brain. Rather, they are debris. This debris will ultimately damage the brain. In addition to causing damage to the brain, a lacunar stroke is also dangerous if it leads to other types of stroke.
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If there are underlying causes of lacunar stroke, they can help target effective secondary prevention regimens. More work is needed to identify the precise patterns of brain lesion in these patients. There is currently no clear answer to the question of whether ICA stenosis is a major factor in this type of stroke, but a detailed patient classification will help guide clinical decisions. In addition, a thorough MRI will help identify whether a lacunar stroke is caused by an embolism.
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A recent study found that small arteries, known as lacunosa, can cause a stroke. These arteries supply the brain's deep forebrain and medial brainstem structures. A lacunar stroke can result in significant neurologic deficits in patients, although it may be more rare than larger ischemic strokes. These strokes may also lead to other types of disability, including impaired communication and co-ordination.
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The authors of a study showed that CTP was superior to NCCT/CTA for the detection of lacunar infarcts in patients with acute stroke symptoms. The study analyzed 1085 CTP examinations in patients who underwent an MRI within seven days. Infarcts greater than two cm were identified in a large subset of patients. The authors analyzed the results to determine the best way to detect lacunar strokes.
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Secondary prevention of atheroma with intensive antiplatelet treatment has not been proven effective in lacunar stroke. Other stroke prevention therapies may work by affecting circulation in addition to the blood-brain barrier. Acute stroke prevention strategies should be considered in these situations, as they may help to prevent the development of other types of strokes. And remember that there is no single treatment for lacunar stroke, and the treatment for lacunar stroke may depend on the symptoms and the type of ischemic disease
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