Lacunar Infarcts

Infromations about Lacunar Infarct, Lacunar Stroke and Lacunar Treatment

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Lacunar Infarct Prognosis

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A lacunar infarct can be described in much the same way as many other vascular diseases. In short, it is a stroke, but typically it is one that is not as readily felt or noticed by either the victim or family members. It is sometimes referred to as a silent stroke. An infarct can pose several dangers to the patient which can be detrimental to lacunar infarct prognosis unless the disease is adequately recognized and treatment is started within a reasonable amount of time. With proper treatment, the lacunar infarct prognosis is actually quite good.

A silent stroke is caused by the same issues that cause other types of strokes. This is usually a blood clot that occurs deep inside the brain, thus temporarily closing off the blood supply to a particular part of the brain. While symptoms of a full blown stroke often involve complete loss of strength or movement on one side of the body coupled with facial drooping, the symptoms of a silent stroke are much more subtle and more difficult to detect. Many times, even the patient is largely unaware that a serious problem has occurred.

Specifically, the symptoms of a silent stroke often only involve difficulty speaking. This is not because the cognitive abilities of the patient have been adversely affected, but because the patient often does not have full muscular control over the tongue, thus making speaking a challenge. The symptoms are typically rather short-lived. Another problem associated with many silent strokes is that they often tend to occur during sleep, thus denying the patient the opportunity to get effective treatment.

This directly affects the outcome of a patient’s general health and has a dramatic impact on the prognosis of a person who has suffered one or more silent strokes. When prompt medical treatment is administered a silent stroke usually does minimal damage and the patient often regains his or her ability to fully function very quickly. In these cases, the long-term prognosis is not adversely affected by having suffered a silent stroke. However, in cases where patients suffer one or more silent strokes and do not receive prompt medical treatment serious complications can arise. These patients often suffer an increased risk of death. This is not necessarily directly related to the silent stroke itself, but moreover as a result of the health problems that caused the stroke in the first place. Because the disease is usually the result of small blood clots, patients who suffer these episodes without realizing that they need medical treatment are left vulnerable to the effects of additional blood clots as time goes on.

The medical conditions that typically lead to these types of strokes are likely to lead to additional health problems such as more serious cerebrovascular accidents or cardiovascular problems. Many of these patients also suffer from hypertension and may suffer adverse effects from the disease unless they are effectively treated. Therefore, the patient who receives prompt medical treatment for a silent stroke fare much better than those who do not. They are often made aware of associated medical conditions and can then undergo effective treatment to reduce their chances of complications. For patients who receive effective treatment there is no reason to assume that they will not be able to live a full and happy life even after suffering a silent stroke.

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Lacunar Infarct Treatment

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Lacunar infarct treatment works to restore function and limit the permanent damage from a stroke. If care begins quickly enough, some drug therapies will actually reverse the symptoms of the stroke fully. The key is to restore the blood supply to deep regions of the brain. With proper treatment, medical science can also reduce the risk of recurrence and correct underlying factors like high blood pressure. Understanding more about lacunar stroke will provide insight on treatment options.

What is a Lacunar Infarct?

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A lacunar infarct is a type of stroke caused by occlusion to the penetrating arteries going deep into the brain. Nestled under the outer layers of the brain are structures that regulate motor response and autonomic functions such as breathing. A blockage in one of the deep penetrating arteries such as the Circle of Willis, cerebellar arteries or basilar artery results is a disruption of blood to this area.

When blood is cut off due to a clot, the person begins show symptoms of Lacunar Stroke Syndrome. It is during this crucial time that lacunar infarct treatment is most effective. The goal is to break up the blockage in the affected artery and restore blood flow.

Symptoms of Lacunar Stroke Syndrome

The symptoms of this condition vary based the affected area of the brain. One can expect inability to move on one side of the body, for example. Other key indicators include:

Weakness localized to a specific region or side
Clumsiness the begins suddenly
Difficulty writing
Persistent numbness
Transient tingling or burning pain

Once symptoms start, getting lacunar infarct treatment becomes critical. Most treatment options need to begin within three hours of the event.

Treatment Options

Treatment for a lacunar infarct primarily focuses on reducing the clotting factors in blood. By thinning the blood, doctors can break up the blockage and restore flow deep into the brain. The sooner this happens, the better the patient prognosis. Physicians will take a multifaceted approach to treating this condition.

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Tissue plasminogen activator – a protein that breaks down blood clots. This will remove the blockage in the artery so brain structures get oxygen and fuel. Treatment with a tissue plasminogen activator such as Activase begins within the first three hours as long as there are no contraindications such as recent surgery.

High dose aspirin is the second treatment approach. This serves to thin the blood and reduce the likelihood of a new clot forming.

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Physiotherapy – brain cells will begin to die within just a few minutes after the stroke. This means some patients will suffer damage even with interventions to remove the clot. The use of physiotherapy can restore some function by helping to create alternative pathways that bypass the damaged areas.

People who suffer from a lacunar infarction have better survival rates than other forms of stroke. As many as 96 percent survive past 30 days and between 70 to 80 percent live independent lives one year of the event. Other forms of stroke, such as hemorrhagic, leave patients with a 50/50 chance of regaining independence.

Advance treatment options like tissue plasminogen activators and aspirin plus a better understanding of the condition increases the odds for those who face lacunar stroke. With proper emergency medical care, doctors can reverse the arterial blockage and reduce the effects of the brain.

What is a Lacunar Stroke?

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Doctors can pinpoint the type of stroke a person had based on the distinctive presentation of symptoms. For example, a cerebral venous thrombosis can start with a severe headache. A stroke that causes drooping of the eyelid is affecting the cranial nerves. A lacunar stroke, or LACI, interferes with deeper brain structures and leads to different symptoms.

What is a Stroke?

The brain is responsible for most actions in the body. It is the organ that allows people to speak, think, feel emotion and evolve. Different areas regulate different functions. When the heart beats, it is due to a signal coming from the medulla oblongata. When the arm reaches up to catch a ball, it does so at the command of the motor cortex in the frontal lobe.

A stroke happens when the blood supply is cut off from part of the brain due to a clot or leak in an artery. Once this occurs, brain cells begin to die within just a few minutes. Doctors diagnosed the type of stroke an individual has based on the area of the brain that shows damage. For example, a person who suddenly loses vision has damage to the occipital lobe of the brain.

What is a Lacunar Stroke?

A lacunar infarct means occlusion to one of the penetrating arteries that take blood deep into the organ. Approximately 25 percent of all strokes that occur due to artery occlusion are this form. When a deep penetrating artery becomes blocked, it cuts the blood supply off to the thalamus, pons area and internal capsule. Different categories of symptoms tell doctors a person has suffered from an infarction deep in the brain.

Pure Motor Stroke – accounts for 50 percent of all lacunar events. This stroke damages fibers that connect the brain to other parts of the nervous system. Imagine a puppet with strings leading to a wooden arm. If the puppet master were to cut one of these strings, the result would be similar to a pure motor stroke. Generally, the body is unable to move on one side, but there are no visual or verbal problems.

Pure Sensory Stroke – A pure sensory stroke has the opposite effect. This blockage leads to the lack of sensation in different areas of the body. For example, it may mean the inability to feel an arm, detect sensation on the face or even cause incontinence.

Sensorimotor Stroke – This indicates a stroke affecting the thalamus and areas adjacent to it. It combines both sensory and motor symptoms. The person might lose movement and feeling on the left side of the body, for instances.

Other Types of Lacunar Strokes

Not all lacunar infarctions are as clear cut as loss of muscle movement or sensation. An ataxic hemiparesis stroke results in weakness only to one side of the body. Dysarthria clumsy-hand stroke means the inability to speak and difficulty controlling one hand.

A stroke of any kind is a serious medical emergency, but the good news is they are more treatable today than they were even ten years ago. A combination of medication and physical therapy can retrain the body to compensate for dead areas even in the deep structures damaged by a lacunar stroke.

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