Lacunar infarcts are a type of stroke that occurs when small blood vessels deep within the brain become blocked or damaged, resulting in a loss of blood flow and oxygen to the affected area. These infarcts are characterized by small, fluid-filled cavities in the brain that can cause a variety of symptoms, depending on their location.
Lacunar infarcts are most commonly caused by hypertension, or high blood pressure, which can damage the walls of small blood vessels over time and increase the risk of blood clots. Other risk factors for lacunar infarcts include diabetes, smoking, and high cholesterol.
What Is the Cause of Lacunar Infarcts?
A lacunar stroke is caused by the interruption of blood flow to the brain in one of the small blood vessels within the brain, known as the deep perforating arteries. This interruption of blood flow can occur due to the formation of a blood clot, atherosclerosis (narrowing of the blood vessels), or high blood pressure. Other potential underlying causes may include diabetes, smoking, and high cholesterol levels. These factors can lead to the formation of fatty deposits and plaque within the blood vessels that supply blood to the brain, which can ultimately result in a lacunar stroke.
What Are the Symptoms of Lacunar Infarcts?
The symptoms resulting from lacunar infarcts are variable, and contingent upon the size and position of the infarction. The symptoms typically develop suddenly and may worsen over time. Weakness or numbness on one side of the body, which can affect the face, arm, or leg, is the predominant indication of a lacunar infarct. This is because the infarct affects the part of the brain that controls movement and sensation on the opposite side of the body. The intensity of the weakness can vary from mild to severe, and it can impede the ability to carry out routine activities, such as grasping items or walking.
Other common symptoms of lacunar infarcts include difficulty speaking or understanding speech, known as aphasia. This may manifest as slurred speech, difficulty finding the right words, or difficulty understanding what others are saying. Patients may also experience problems with coordination or balance, making it difficult to walk or perform other physical activities. Alterations in eyesight, like blurred vision, double vision, or a reduction in visual range in one or both eyes, may also manifest. Some patients may experience sudden, severe headaches, which may be accompanied by nausea and vomiting.
In some cases, patients with lacunar infarcts may not experience any symptoms at all. This is because the infarct is small and located in a part of the brain that does not affect movement, sensation, or other functions.
Who Is More at Risk of Lacunar Infarcts?
Individuals with certain medical conditions and lifestyle factors are more at risk of experiencing a lacunar stroke. These risk factors include:
High Blood Pressure: Lacunar stroke is considerably linked with hypertension, which if left unattended, can result in clot formation, accumulation of plaque, and harm to the tiny blood vessels within the brain.
Diabetes: Individuals with diabetes have an increased probability of developing lacunar stroke due to the potential of diabetes to cause harm to blood vessels, rendering them more susceptible to narrowing and clotting.
Smoking: Smoking is a major risk factor for lacunar stroke. It can damage the blood vessels and cause plaque buildup, increasing the likelihood of clot formation.
High Cholesterol: Elevated cholesterol levels in the bloodstream can promote the buildup of plaque within blood vessels, culminating in a heightened probability of lacunar stroke.
Age: Lacunar stroke is more common in older adults, especially those over 65 years of age.
Race and Ethnicity: Some studies suggest that African Americans and Hispanic Americans may be at a higher risk of lacunar stroke compared to other racial and ethnic groups.
How to Diagnose Lacunar Infarcts?
The diagnosis of lacunar infarcts typically involves a combination of medical history, physical examination, and imaging tests.
Medical History: The doctor will ask about the patient's medical history and risk factors for stroke, such as high blood pressure, diabetes, smoking, and high cholesterol.
Physical Examination: During a physical examination, the doctor checks the patient's blood pressure, heart rate, and other vital signs. Assessment of the patient's neurological function, including their reflexes, muscle strength, and coordination is also made.
Imaging Tests: Imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scans can help identify the location and size of the infarct. MRI scans are more sensitive than CT scans for detecting small infarcts, but CT scans may be more readily available in some hospitals.
Other tests that may be performed to help diagnose lacunar infarcts include an electrocardiogram (ECG) to assess for heart abnormalities, blood tests to check for ailments that can augment the likelihood of stroke, and carotid ultrasound to inspect for obstructions in the carotid arteries that provide blood to the brain.
What Is the Treatment for Lacunar Infarcts?
Getting prompt treatment for a lacunar stroke can improve the chances of survival and prevent further damage. When a person arrives at the emergency room, healthcare providers may suggest Aspirin and other medications to lower the risk of having another stroke.
While in the hospital, assistance may be required to support breathing and heart function. Intravenous clot-busting medications may be administered, and for severe lacunar infarcts, medications can be directly delivered into the brain by a doctor. In cases where anti-clotting treatments are ineffective, a mechanical thrombectomy procedure can be performed by a neurosurgeon to remove blockages or clots from the brain.
Rehabilitation: A lacunar stroke can lead to brain damage, which may affect a person's ability to care for themselves after the stroke, depending on the extent of the damage to the underlying structures. The recovery process varies for each individual and is dependent on the severity of the stroke. Some individuals may move to a rehabilitation center or nursing home temporarily after being discharged from the hospital, where they may have to relearn physical movements and regain their strength. This process can take a varying amount of time, ranging from weeks to months or even years.
Long Term Treatment: Long-term treatment is typically necessary for most individuals who have experienced a stroke in order to minimize their risk of having another one. This treatment may include taking medication to manage conditions like high blood pressure, diabetes, and high cholesterol. Additionally, individuals who have experienced a lacunar stroke may require physical therapy to restore lost function, occupational therapy to enhance their ability to carry out daily activities, and speech therapy to recover lost communication skills.
How to Prevent Lacunar Infarcts?
A lacunar stroke can present a life-threatening emergency. While some risk factors like aging and family history are beyond an individual's control, certain lifestyle modifications such as maintaining a healthy diet, abstaining from smoking, and engaging in at least 150 minutes of exercise per week can influence the risk of developing a lacunar stroke. These habits, when practiced together, can help lower the risk of experiencing a lacunar stroke.
Individuals with pre-existing conditions such as high blood pressure, heart disease, or diabetes should work to keep them under control and regularly see their doctor. Above all, it is crucial to seek medical attention as soon as possible at the first sign of stroke, as every moment could potentially be life-saving.
In conclusion, a lacunar stroke is a type of stroke caused by a blockage in the small blood vessels within the brain. It can result in brain damage and other long-term complications. Risk factors for lacunar stroke include high blood pressure, diabetes, smoking, high cholesterol, age, family history, and race or ethnicity. To mitigate the risk of experiencing a lacunar stroke, it is recommended to uphold a healthy lifestyle, manage any pre-existing medical conditions, and promptly seek medical aid upon noticing any indications of a stroke. Early treatment is crucial in increasing the chances of survival and preventing further damage.