lacunar stroke guide_ causes, symptoms and treatment options

What Is It?

Strokes can damage brain tissue in the outer part of the brain (the cortex) or deeper

structures in the brain underneath the cortex. A stroke in a deep area of the brain (for

example, a stroke in the thalamus, the basal ganglia or pons) is called a lacunar stroke .

These deeper structures receive their blood flow through a unique set of arteries.

Because of the characteristics of these arteries, lacunar strokes happen a little bit

differently from other strokes.

A lacunar stroke occurs when one of the arteries that provide blood to the brain's deep

structures is blocked. These arteries are small, and are uniquely vulnerable. Unlike most

arteries, which gradually taper to a smaller size, the arteries of a lacunar stroke branch

directly off of a large, high-pressure, heavily muscled main artery. High blood pressure

(hypertension) can lead to lacunar strokes because it causes a pounding pulse. Since the

arteries don't gradually taper down in their size, high blood pressure can directly damage

these arteries. High blood pressure also can cause atherosclerosis, a condition in which

fatty deposits (plaques) build up along the walls of blood vessels. When atherosclerosis

is present, a clot can form inside of one of these small arteries, blocking blood flow in the

artery.

Lacunar Stroke Guide: Causes, Symptoms and Treatment Options http://www.drugs.com/health-guide/lacunar-stroke.html

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Unlike strokes that damage the cortex, lacunar strokes are only rarely caused by a blood

clot (also called a "thrombus") that forms elsewhere in the body, such as the neck or

heart, and travels through the bloodstream to the brain. After a clot (or any debris) begins

to travel through the bloodstream it is called an embolus. It is difficult for an embolus to

make its way into the small arteries that can cause a lacunar stroke.

Many of the deep brain organs that can be injured by a lacunar stroke help to relay

communication between the brainstem and the brain cortex, or help to coordinate

complicated body movements. In a lacunar stroke, brain cells in a relatively small area

(measuring from 3 millimeters to as much as 2 centimeters across) are damaged or killed

by lack of oxygen. Such a small area of brain destruction is called a lacune. A lacunar

stroke involves only a small area of the brain, but it can cause significant disability.

Lacunar strokes account for about 20 percent of all strokes in the United States.

Symptoms

The symptoms of lacunar stroke vary depending on the part of the brain that is deprived


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Symptoms can include:

Weakness or paralysis of the face, arm, leg, foot or toes

Sudden numbness

Difficulty walking

Difficulty speaking

Clumsiness of a hand or arm

Weakness or paralysis of eye muscles

Other neurological symptoms

In a person with prolonged, untreated high blood pressure, multiple lacunar strokes can

occur. This can cause additional symptoms to develop, including emotional behavior and

dementia.

The sudden appearance of one or more of these symptoms is a warning sign that a

stroke may be in progress. Sometimes, the small clots that can cause a lacunar stroke

interfere with blood flow only for a few minutes. If the clot dissolves before damage is

done, then symptoms can begin to improve within minutes and may go away completely.

When symptoms go away without treatment and full recovery occurs within 24 hours, the

event is called a transient ischemic attack (TIA). Never decide to wait and see whether

stroke symptoms will go away on their own. Get to an emergency room as quickly as

possible to get treatment.

Diagnosis

Your doctor will ask about your medical history (high blood pressure, heart disease,

smoking, high cholesterol and diabetes). He or she will check your vital signs

(temperature, pulse, breathing rate and blood pressure) and might order an

electrocardiogram (EKG).


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Expected Duration

If your symptoms continue without improvement during the time you are traveling to an

emergency center, it is best to assume that your event is a full-blown stroke, not a TIA. If

a lacunar stroke is treated early, full recovery is possible. If medicines restore circulation

to the brain quickly, symptoms of a lacunar stroke may go away within hours. If blood

supply is interrupted for a longer time, brain injury may be more severe, and symptoms

may last for many weeks or months, requiring physical rehabilitation. There may be

permanent disability.

Prevention

You can help to prevent lacunar stroke by preventing or controlling the risk factors for

stroke high blood pressure, smoking, heart disease and diabetes. If you have high

blood pressure or heart disease, follow your doctor's recommendations for modifying

your diet and taking your medication. Exercise regularly, eat plenty of fruits and

vegetables, and avoid foods filled with saturated fats and cholesterol. If you smoke, quit.

If you have diabetes, monitor your blood sugar level frequently, follow your diet, and take

your insulin or oral diabetes medication as your doctor has prescribed.

If you have had a lacunar stroke, your doctor may recommend a daily aspirin or other

blood-thinning medication, such as ticlopidine (Ticlid) or clopidogrel (Plavix). These

medicines may reduce your risk, but their benefit has been more obvious for stroke types

other than lacunar strokes. If you have never had a stroke of any kind, you might lower

your risk for a first stroke if you take a daily aspirin. There is strong evidence that stroke

risk is reduced for women over the age of 45 who take aspirin once every other day. This

benefit has not been proven for men.

Treatment

If doctors are able to provide treatment within three hours after symptoms start, they


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A person who has had a lacunar stroke usually is hospitalized so that he or she can be

observed in case symptoms worsen. A person with a severe stroke may need help with

self-care or feeding. In the hospital, an occupational therapist and a physical therapist

can help the person to work around a new disability and to regain strength after brain

injury. Commonly, hospitalization is followed by a period of residence at a rehabilitation

center, where additional intensive therapy may be given. The goal of rehabilitation is to

maximize recovery. To prevent future strokes, it is very important for you to control high

blood pressure. It helps to take a daily aspirin or other blood-thinning medication

(ticlopidine or clopidogrel).

When To Call a Professional

Call for emergency treatment immediately whenever the symptoms of lacunar stroke

occur, even if these symptoms last only a few minutes. For best results, stroke treatment

must occur within three hours of the start of symptoms.

Prognosis

People often begin to recover within hours or days of a lacunar stroke. Lacunar strokes

have a better rate of recovery than other strokes that involve larger blood vessels. More

than 90 percent of people with a lacunar stroke will recover substantially within the first

three months following the stroke.

Learn more about Lacunar Stroke

Symptoms and treatment for:

Heat Stroke (Hyperthermia)

Hemorrhagic Stroke

Intracranial Aneurysms


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Thrombotic Stroke

Transient Ischemic Attack (TIA)

External resources

National Institute of Neurological Disorders and Stroke

P.O. Box 5801

Bethesda, MD 20824

Phone: 301-496-5751

Toll-Free: 1-800-352-9424

TTY: 301-468-5981

http://www.ninds.nih.gov/

National Stroke Association

9707 E. Easter Lane

Englewood, CO 80112

Phone: 303-649-9299

Toll-Free: 1-800-787-6537

Fax: 303-649-1328

http://www.stroke.org/

Disclaimer: This content should not be considered complete and should not be used in place of a call

or visit to a health professional. Use of this content is subject to specific Terms of Use & Medical

Disclaimers.


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lacunar stroke guide_ causes, symptoms and treatment options

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