Lacunar Stroke: Symptoms, Treatments, and Long-Term Outlook
What Is a Lacunar Stroke?
A stroke is an event in which blood flow to the brain is interrupted or blocked, causing brain cells to become damaged and die. Strokes caused by blood clots are called ischemic strokes. Lacunar stroke is a type of ischemic stroke that occurs when blood flow to one of the small arterial vessels deep within the brain becomes blocked. According to the National Institutes of Health (NIH), lacunar stroke represents about one-fifth of all strokes. The most common cause of lacunar stroke is chronic high blood pressure.
What Causes Lacunar Stroke?
Lacunar stroke is caused by lack of blood flow in smaller arteries that supply deep brain structures. A common cause is chronic high blood pressure, leading veins to narrow, making it easier for blood clots to block blood flow.
Lacunar stroke can also occur after a silent cerebral infarction, an injury caused when a blood clot interrupts blood flow to the brain. Other causes of stroke include plaque buildup on the artery walls (atherosclerosis) or in the carotid arteries (carotid artery disease), and irregular heartbeat (atrial fibrillation), which causes blood to pool and clot.
Who Is at Risk?
Risk of stroke increases with age. Those most at risk are people with chronic high blood pressure, heart disorders, or diabetes. African-Americans, Hispanics, and people with a family history of stroke are at higher risk than other groups. According to the American Stroke Association, more men have strokes than women.
Other factors that increase the likelihood of stroke include:
- drug abuse
- use of birth control pills
- sedentary lifestyle
- poor diet
What Are the Symptoms?
Early signs of stroke include slurred speech, inability to raise one arm, and one side of the face appearing droopy. Symptoms of stroke usually come on suddenly and without warning. As brains cells die, functions controlled by that area of the brain are affected. Depending on the location of the stroke, symptoms may include numbness, often on only one side of the body, and difficulty walking or moving the arms. There may be confusion, memory problems, and a struggle to speak or understand spoken language. Headache occurs in some cases. Stroke can lead to loss of consciousness or coma.
How Is Stroke Diagnosed?
Emergency treatment is necessary for any type of stroke, so diagnosis is urgent. If symptoms are consistent with stroke, immediate diagnostic testing will likely include a CT scan, MRI scan, angiogram, or Doppler ultrasound.
Heart function tests, such as electrocardiogram and echocardiogram may be ordered, along with kidney and liver function testing and various blood tests.
What Is the Treatment for Stroke?
Early treatment increases your chance of survival and may prevent further damage. In the event of a stroke, supportive measures may be needed to assist your breathing and heart function. You may be given oral or intravenous clot-busting drugs. Using a catheter, doctors can deliver medications directly into the brain.
You may not be able to care for yourself following a stroke. Some stroke patients transition from the hospital to a rehabilitation center or nursing home, at least for a short period of time. Most stroke patients require long-term treatment that may include medication, physical and occupational therapy, and speech and language therapy.
What Is the Long-term Outlook?
Quality of life depends on many factors, including age and how quickly treatment was started. For some patients, disabilities are permanent. Other patients can improve their physical and mental functioning with various therapies. Many will require ongoing treatment and medication. Having a stroke increases risk of subsequent strokes, so regular medical care is very important.
According to the American Stroke Association, although incidence of stroke is higher in men, women represent more than half of stroke deaths across all age groups.
Lower Your Risk
Stroke is a life-threatening emergency. Some risk factors, like aging and family history are beyond our control, but certain lifestyle behaviors can be changed. You can lower your chance of stroke by maintaining a healthy diet and exercising regularly. If you have high blood pressure, heart disease, or diabetes, see your doctor regularly and work to keep your condition under control. Don’t smoke. Seek medical attention at the first sign of stroke – every second matters.
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