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Lacunar Stroke

What is a lacunar stroke?

Key points

  1. Lacunar stroke is a type of ischemic stroke that occurs within the deepest structures of the brain.
  2. Having a lacunar stroke can increase your risk of subsequent strokes.
  3. As with all types of strokes, quick diagnosis and treatment is key to minimizing damage to the brain.

A stroke occurs when blood flow to the brain is interrupted or blocked. Strokes that are caused by blockages in blood vessels within the brain are called ischemic strokes. Lacunar stroke is a type of ischemic stroke that occurs when blood flow to one of the small arteries deep within the brain becomes blocked.

According to the National Institutes of Health (NIH), lacunar stroke represents about one-fifth of all strokes. Any type of stroke is dangerous because brain cells are deprived of oxygen and begin to die within minutes.

What are the symptoms of lacunar stroke?

Symptoms

Symptoms of stroke usually come on suddenly and without warning. Signs of lacunar stroke can include:

  • slurred speech
  • inability to raise one arm
  • one side of the face appearing droopy
  • numbness, often on only one side of the body
  • difficulty walking or moving the arms
  • confusion
  • memory problems
  • struggle to speak or understand spoken language
  • headache
  • loss of consciousness or coma

As brains cells die, functions controlled by that area of the brain are affected. These symptoms can vary depending on the location of the stroke.

What causes lacunar stroke?

Causes

Lacunar stroke is caused by lack of blood flow in smaller arteries that supply deep brain structures. The most important risk factor for the development of lacunar stroke is chronic high blood pressure. The condition can cause the arteries to narrow. This makes it easier for cholesterol plaques or blood clots to block blood flow to the deep brain tissues.

Who is at risk for lacunar stroke?

Risk Factors

Risk of lacunar stroke increases with age. Those at risk include people with chronic high blood pressure, heart disorders, or diabetes. African-Americans, Hispanics, and people with a family history of stroke are also at a higher risk than other groups.

Other factors that increase the likelihood of lacunar stroke include:

  • smoking or exposure to secondhand smoke
  • alcohol
  • drug abuse
  • pregnancy
  • use of birth control pills
  • sedentary lifestyle
  • poor diet
  • high cholesterol
  • obstructive sleep apnea

Annual physical examinations are important to screen for various health issues, including high cholesterol and obstructive sleep apnea.

How is lacunar stroke diagnosed?

Diagnosis

Emergency treatment is necessary for any type of stroke, so diagnosis is urgent. Your doctor may take your blood pressure and ask about your symptoms. A detailed neurological exam will be used to see if there is any damage to the nerve pathways throughout the body.

If your symptoms are consistent with stroke, immediate diagnostic testing will likely include a CT scan or a MRI scan to take detailed images of your brain. A Doppler ultrasound may also be used. This will measure the amount of blood flowing through your arteries and veins.

Heart function tests, such as electrocardiogram and echocardiogram may be ordered. Kidney and liver function testing and various blood tests may also be administered.

What is the treatment for lacunar stroke?

Therapy

If you have a lacunar stroke, early treatment increases your chance of survival and may prevent further damage. Once you arrive at the emergency room, you'll likely be given aspirin. This reduces the risk of having another stroke.

Supportive measures may be needed to assist your breathing and heart function. You may receive oral or intravenous clot-busting drugs. In extreme circumstances a doctor can deliver medications directly into the brain.

Lacunar stroke can result in some brain damage. Depending how badly the underlying structures are damaged, you may not be able to care for yourself following a stroke. Recovery varies for each person and depends on the severity of the stroke.

Some lacunar stroke patients transition from the hospital to a rehabilitation center or nursing home, at least for a short period of time. Because of brain damage, stroke patients often have to re-learn skills and regain their strength. This can take weeks, months, or years.

Most stroke patients require long-term treatment. This can include medication to treat high blood pressure, diabetes, or high cholesterol. After a lacunar stroke, some patients also require:

  • physical therapy to restore function
  • occupational therapy to improve skills needed for everyday living
  • speech therapy to improve language skills

What is the long-term outlook?

Outlook

Quality of life after lacunar stroke depends on many factors, including age and how quickly treatment began after symptoms started. For some patients, disabilities are permanent. These can include:

  • paralysis,
  • numbness
  • loss of muscle control on one side of the body
  • tingling sensation in affected limb

Even after rehabilitation and stroke recovery, some stroke survivors have problems with short-term memory. Some may also have difficulty with thinking and reasoning. Controlling your emotions can also be an issue. Some stroke survivors also deal with depression.

Having a lacunar stroke increases your 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

Prevention

Lacunar stroke is a life-threatening emergency. Some risk factors such as aging and family history are beyond your control, but certain lifestyle behaviors can influence risk. Maintain a healthy diet. Exercise regularly for at least 30 minutes most days of the week. Together these habits can help lower your risk of having a lacunar stroke.

If you have high blood pressure, heart disease, or diabetes, see your doctor regularly. Strive to keep under control any of these conditions that you may have. Don’t smoke. And most importantly, seek medical attention at the first sign of stroke – every second matters.

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