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.
A stroke occurs when a blockage interrupts or prevents blood flow to the brain. Strokes that occur due to blockages in blood vessels within the brain are called ischemic strokes.
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We explain essential information about lacunar strokes, including the symptoms, causes, and treatments, as well as how to reduce your risk.
As lacunar infarcts are small, they often do not cause symptoms. Often, they show up on brain scans before people are even aware they’ve happened.
When symptomatic, a lacunar stroke usually comes on suddenly and without warning. Symptoms may include:
- slurred speech
- inability to raise one arm
- drooping on one side of the face
- numbness, often on only one side of the body
- difficulty walking or moving your arms
- memory problems
- difficulty speaking or understanding spoken language
- loss of consciousness or coma
The death of brain cells can disrupt some of the bodily functions the cells supported. For this reason, symptoms can vary depending on the location of the stroke.
A lacunar stroke occurs due to a 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.
A few different groups of people might have a higher risk for lacunar stroke than others.
People with underlying health conditions
Some chronic health problems can cause a lacunar infarct as a complication, including:
- chronic high blood pressure
- heart disorders
- atherosclerosis, which causes plaque to develop on the walls of your arteries
- peripheral artery disease, which can lead to narrowed blood vessels
- high levels of an amino acid called homocysteine that usually suggests a vitamin B-12 or folate deficiency
- a history of transient ischemic attacks, or ministrokes
Some research has indicated that lacunar infarct might occur more often in Black people than in white people.
More research needs to take place, and the studies didn’t clarify whether this difference in risk was due to genetic or socioeconomic factors.
Those with genetic factors
People with a family history of stroke might also have a higher risk for lacunar infarct than other groups.
Additional factors that increase the likelihood of lacunar stroke include:
- smoking or exposure to secondhand smoke
- excessive alcohol and drug use
- using birth control pills
- a sedentary lifestyle
- a diet that doesn’t provide a wide enough range of nutrients
- high cholesterol
- obstructive sleep apnea
It’s important to have annual physical examinations to screen for health issues that could raise your risk for stroke, including high cholesterol and obstructive sleep apnea.
Emergency treatment is necessary for any type of stroke, so it’s imperative to seek diagnosis immediately upon noticing any symptoms.
If your symptoms are consistent with stroke and present a medical emergency, immediate diagnostic testing will likely include a CT scan to take detailed images of your brain. Because lacunar strokes are so small and don’t show up clearly on CT imaging, a doctor may not be able to confirm diagnosis unless other tests are performed.
Magnetic resonance imaging (MRI) is a more accurate imaging option for lacunar infarct.
The doctor might also request a CT angiography. This will help them check your blood vessels for blockages.
Your doctor may take your blood pressure and ask about your symptoms. They may also carry out a detailed neurological exam to see if there is any damage to the parts of the brain that control your bodily functions.
Early treatment for a lacunar stroke increases your chances of survival and may prevent further damage.
When you get to hospital
Once you arrive at the emergency room, a healthcare professional will likely recommend aspirin and other medications. This reduces your risk of having another stroke.
While you’re staying in the hospital
Supportive measures may be necessary to assist your breathing and heart function.
You may receive intravenous clot-busting drugs. For people with severe lacunar infarct, a doctor can deliver medications directly into the brain.
If these anti-clotting treatments don’t have the desired effects, a neurosurgeon can remove a clot or blockage from the brain in a procedure called a mechanical thrombectomy.
Lacunar stroke can result in some brain damage. Depending on 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 people who experience a lacunar stroke transition from the hospital to a rehabilitation center or nursing home, at least for a short period of time. Stroke patients often have to relearn physical movements and regain their strength.
This can take weeks, months, or years.
Most people who experience a stroke require long-term treatment to reduce their risk for another stroke. This might include medications to manage:
After a lacunar stroke, some people also require:
Quality of life after lacunar stroke depends on many factors, including your age and how quickly your treatment began after symptoms started. Some people live with permanent disabilities. These can include:
- loss of muscle control on one side of the body
- a 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, reasoning, and controlling emotions. Depression can also be an issue for some stroke survivors.
Having a lacunar stroke increases your risk of subsequent strokes, so regular medical care is crucial for recovery.
Lacunar stroke can be a life-threatening emergency.
Some risk factors, such as aging and family history, are beyond your control, but certain lifestyle behaviors can influence risk, like maintaining a healthy diet, avoiding smoking, and exercising for at least 150 minutes per week. Together, these habits can help lower your risk of having a lacunar stroke.
If you have high blood pressure, heart disease, or diabetes, try to keep it under control and see your doctor regularly. Most importantly, seek medical attention at the first sign of stroke — every second could save your life.