Lacunar Stroke - Oren Zarif - Lacunar Stroke
A lacunar stroke affects the brain, which is the source of voluntary movements. When this part of the brain suffers a stroke, it affects many other parts of the body as well. Because of its size, it does not show up clearly on a CT scan, so doctors usually use magnetic resonance imaging (MRI) or CT angiography to diagnose it. Although the MRI is more sensitive, CT angiography can still be helpful in identifying a lacunar stroke.
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The study results confirm the vascular and geriatric theories that link age and risk of developing a lacunar stroke. The study findings also confirm previous studies that suggest lacunes increase with age. Older people are at greater risk for developing lacunes and the rate of new cases is only 1.6%. The association between high blood pressure and the risk of developing a lacunar infarction was also clearly demonstrated. However, no associations were found between alcohol, diabetes, and weight.
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The researchers compared the genetic codes of 7,338 lacunar stroke patients with those of 25,4798 healthy people. They discovered that those who suffer from a lacunar stroke have genetic changes that make their small blood vessels "leaky." These changes are believed to make the brain less able to remove toxins, which could damage its function. Consequently, the messages traveling around the brain would be slower or stop altogether. The researchers hope to complete clinical trials in the next decade.
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While MRI and CT are not able to reveal the precise location of lacunar infarcts, they can show the spatial distribution of WMH. In fact, more than half of group A and 20% of the group B participants had at least one lacunar infarct in the MRI. Although blood pressure did not seem to affect the size of lacunes, the ventricle-brain ratios were significantly higher in group A patients.
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Following a lacunar ischemic event, the patient's care will involve a multidisciplinary team of health professionals. Neurologists, physical therapists, occupational therapists, and social workers will treat the physical deficits of the patient. Muscle relaxants may help manage spasticity. Pharmacists are essential to check drug interactions. Outpatient rehabilitation therapy should continue until neurologic function returns to its pre-infarction baseline.
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A clinical examination includes measuring blood pressure, drawing blood samples, and collecting cells from the inside of the mouth to study DNA. The study participants were classified into 3 groups according to their blood pressure, namely, definite hypertension, borderline hypertension, and normotensive. The study participants were also divided based on their history of diabetes. The authors also performed MRI scans to detect lacunar strokes. And, because this type of stroke is relatively uncommon, it should not be dismissed as a diagnosis without a thorough evaluation.
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Researchers have shown that a quarter of all cases of ischaemic strokes are lacunar. The cause of lacunar stroke is unclear, but it is believed to contribute to vascular dementia and other diseases. It also affects patients with multiple sclerosis, and is the leading cause of ischemic stroke in these patients. If not diagnosed and treated, a patient may develop vascular dementia and other conditions associated with the disease.
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During the first few hours after a TIA, doctors may give clot-busting medications via intravenous injection. Some people who experience a lacunar infarct may require surgery to remove the blockage or clot. Ultimately, patients with a lacunar stroke may require physical rehabilitation and may not fully recover after the stroke. However, if the symptoms persist, a lacunar stroke is usually treatable with the right medicine.
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Although there are no definitive causes of lacunar infarct, some people are more at risk for the disease than others. Those with diabetes, high blood pressure, and heart disorders are at a higher risk. People with a history of stroke may also be at risk. Getting an annual physical examination may help identify other health conditions that raise the risk of a stroke. For instance, obstructive sleep apnea and high cholesterol can raise the risk of a stroke. No matter the type, however, emergency treatment is essential.
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Another type of lacunar stroke is known as a mixed sensorimotor stroke. The symptoms of a lacunar stroke will be different depending on the location of the damage to the brain. While a pure sensory stroke will result in weakness of one side of the body, a mixed sensorimotor stroke will cause impairments in the opposite side. This type of stroke is more likely to cause a hemiparesis, which affects the opposite side of the body.
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