Lacunar Stroke - Oren Zarif - Lacunar Stroke
A lacunar stroke is the least common type of ischemic stroke. It is typically small, causing little to no symptoms. While some lacunes are the result of an embolism, this is a relatively low percentage of the cases. The clinical and epidemiologic basis for lacunes' separation from other ischemic stroke types is clear. This article discusses the most common causes of lacunar stroke, including the signs and symptoms that accompany this type of stroke.
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A person with a lacunar stroke will experience various symptoms depending on the part of the brain that was deprived of blood. Different parts of the brain control different functions, including sensation, movement, speech, and balance. People with prolonged, untreated high blood pressure are at a higher risk for multiple lacunar stroke, which can lead to mental problems, emotional behavior, and dementia. Patients should seek immediate medical care if they experience any of these symptoms.
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During an initial visit to a doctor, your medical history will be taken. Your doctor will also check your vital signs and order an electrocardiogram. Imaging tests will show if there are any intracranial hemorrhages. Other symptoms associated with a lacunar stroke include ataxic hemiparesis, facial weakness, and dysphagia. Once a diagnosis is made, the next step is to determine whether you have other conditions such as a brain tumor.
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A study of 131 patients with a lacunar infarction found that 62% of patients had fluctuating onset of hemiparesis. Although there was no study of the progression of motor deficits in the lacunes after the stroke, extensive embolic workup is necessary to make a definitive diagnosis. If you do develop a lacunar stroke, emergency medical care should be sought. And if it's an unrelated cause, you should seek medical attention.
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Several issues with current research on lacunar stroke are worth noting. One is the paucity of pathological material. Researchers have not been able to identify the cause of this rare neurological condition, and as such, have to speculate that it may be a complication of a traumatic brain injury. The study also lacked a control group for comparison. A large sample size would help them find the best treatment for lacunar stroke patients. Secondly, the researchers need to improve the quality of clinical trials.
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One type of lacunar stroke is characterized by the presence of a second silent lacunar lesion. The patient's prognosis will be worse if he or she has 2 silent lacunar lesions, but they have less disability overall. The patient will require intensive care and a prolonged rehabilitation program. However, lacunar strokes do not usually result in death. However, they are still an important cause of disability for people suffering from a stroke.
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One cause of this type of ischemic stroke is the presence of other risk factors. Among these, diabetes and hypertension are the most common. These two risk factors have been found to be equally common in lacunar infarctions. Additionally, diabetes and aging are significant factors in the development of lacunar stroke, although their prevalence is not clear. There are also many studies on the causes of lacunar stroke and how to prevent it.
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Because of the nature of this condition, it is important to treat the patient promptly. Even after discharge from the hospital, physical therapy, occupational therapy, speech therapy, and rehabilitation services are essential. Treatment should focus on reducing risk factors such as alcohol and smoking. Patients should also adhere to their treatment plan as prescribed by their primary care provider. The treatment for lacunar stroke varies according to the individual's condition, determining which treatment method is best for them.
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The best imaging modality for lacunar infarction is MRI. The diffusion-weighted MRI provides the best diagnostic accuracy and helps distinguish acute infarction from chronic. On T1 and T2-weighted images, lacunes appear as focal areas of decreased signal intensity and hyperintensity, while lesions with a chronic course are isointense to the CSF. There are many nuances of lacunar stroke, but one important factor is that this imaging modality is incredibly sensitive.
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CTP can detect lacunar infarcts by different intracranial regions. The highest sensitivity for CTP is observed in the subcortical white matter, whereas the lowest sensitivity for CTP is found in the basal ganglia. The highest sensitivity for NCCT/CTA was 98.7% for the two-dimensional images. NCCT/CTA, however, did not detect lacunar infarcts.
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