Lacunar Stroke

A lacunar stroke is a blockage of blood flow to a part of the brain supplied by one or more small arteries. In a lacunar stroke, a blood clot (thrombus) blocks blood flow. Lacunar strokes , a subtype of ischemic stroke, have earned their name because the area rendered ischemic takes the form of a small lacune or cavity (usually less than 15mm in diameter). Unlike most arteries that gradually taper to a smaller size, the arteries of a lacunar stroke branch directly off of a large, high pressure, heavily muscled main artery. A much larger infarct may actually produce a less extensive (or intrusive) neurologic deficit for the patient Lacunar strokes account for about 20 percent of all strokes in the United States.

Much of our current knowledge of lacunar strokes is due to Fisher's prior cadaveric dissection of post-mortem stroke patients. High blood pressure (hypertension) is a major contributor to lacunar strokes because of the pounding pulse it causes Lacunes may be defined as small subcortical infarcts (<15 mm in diameter) in the territory of the deep penetrating arteries and may present with specific lacunar syndromes or may be asymptomatic.. As far as we know, this patient did not show any specific neurologic deficits related to these infarcts It also can dislodge small clumps or clots that can block blood flow

Causes of Lacunar Stroke

Here are the list of the possible causes of Lacunar Stroke:

• Diabetes mellitus is well recognized as a risk factor for development of small vessel disease throughout the body, including the penetrating arteries.
• Although a recent study showed that the benefit of endarterectomy in patients with lacunes was smaller than in patients with nonlacunar strokes, the procedure is superior to medical therapy
• The cells of that part of the brain die as a result. Typically, a clot forms in a small blood vessel within the brain that has been previously narrowed due to the long-term, damaging effects of high blood (hypertension) or diabetes.
• A cerebral hemorrhage (bleeding in the brain) can cause a stroke by depriving blood and oxygen to parts of the brain.

Symptoms of Lacunar Stroke

Some sign and symptoms related to Lacunar Stroke :

• Weakness or paralysis of the face, arm, leg, foot or toes
• Sudden numbness
• Trouble walking, dizziness, loss of balance, or coordination
• Difficulty with muscle movements, such as swallowing, moving arms and legs
• Uncommonly, patients may experience seizures
• Weakness or paralysis of eye muscles
• People at risk and partners or caretakers of people at risk for stroke should be aware of the general symptoms, and the stroke victim should get to the hospital as soon as possible after these warning signs appear.

Treatment of Lacunar Stroke

• After initial assessment, a physical therapy program should begin with passive exercises, where the major joints of the paretic limb are moved through a full range of movement (ROM).
• A speech-language therapist can assist with speech-language problems and swallowing disorders. Early assessment of a patient with swallowing problems may prevent dehydration and malnutrition from inadequate intake, as well as prevent aspiration and pneumonia.
• Patients with clot-related (thrombotic or embolic) stroke who are ineligible for t-PA treatment may be treated with heparin or other blood thinners, or with aspirin or other anti-clotting agents in some cases.
• In this procedure, a catheter is guided from a larger artery up into the brain to reach the aneurysm.

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