Lacunar infarction: causes, symptoms and treatment

Stroke (LCA) they consist of an interruption of the blood flow sent to the brain for various causes. When this flow is paralyzed, the brain stops supplying it with oxygen and nutrients, leading to damage or death of brain cells in a specific area of ​​the brain.

But there are different types of strokes, usually these attacks damage the brain tissue in the outermost or superficial area of ​​the brain. however, when this damage occurs in the innermost structures of the brain, it is called a lacunar infarction. We will talk about this type of alteration in the following lines.

    What is a lacunar infarction?

    Lacunar infarction refers to a type of stroke in which one of the arteries that supply blood to the internal structures of the brain is blocked, Leaving the brain without the supply of oxygen and nutrients necessary for its functioning.

    The arteries liable to be damaged during a lacunar infarction are smaller and therefore more fragile than the others, they come directly from a main artery which carries blood with a lot of pressure.

    When a person suffers from a lacunar infarction, cells in a relatively small area of ​​the brain start to damage or die from lack of oxygen. Since a large number of internal brain structures cooperate in communication and coordination of bodily movements, a lacunar infarction can pose a significant risk of involvement of a disability.

    Compared to other types of strokes, lacunar infarctions account for 20% of strokes that people experience.

      Symptoms of lacunar infarction

      Since different areas of the brain control various functions such as movement, sight, speech, etc., the symptoms that warn a person suffering from lacunar infarction will depend on which area of ​​the brain is damaged. These symptoms include:

      • Weakness or paralysis on the face, arm, leg or foot
      • Weakening or paralysis of the eye muscles
      • Sudden muscle numbness
      • Movement problems
      • Speech problems

      If a person with high blood pressure does not receive any kind of treatment, they are very likely to suffer from a series of lacunar infarctions that lead to the development of additional symptoms such as dementia or emotional behavior.

      Likewise, if the person perceives one or more of the above symptoms, they should be alert, as this could also mean that they are about to have a more serious cardiovascular event.

      Types of lacunar syndromes

      As mentioned above, the symptoms and consequences may vary depending on the area of ​​the brain affected by the lacunar infarction.

      There are five main lacunar syndromes, out of a list of about 85. Estons are as follows.

      1. Pure motor syndrome

      In this type of lacunar accident, the person experiences paralysis or a decrease in muscle vigor which similarly affects one side of the body. This paralysis is called hemiparesis and affects about 50% of people who have suffered a lacunar infarction.

      2. Ataxic hemiparesis

      This consequence is characterized by partial paralysis, or paresis, of varying severity and great difficulty in coordinating movements, Or ataxia, of the limbs, the legs being more often affected than the arms.

      3.clumsiness in the hands and dysarthria

      In this case, the person suffers from a decrease in dexterity and precision of hand movements. Outraged, this deficit is accompanied by difficulties in articulating sounds or words caused by weakness or paralysis of the facial muscles, also known as dysarthria.

      4. Pure sensory syndrome

      In pure sensory syndrome, the person experiences 1 continuous or transient numbness on one side of the body. You may also suffer from changes in sensitivity which cause discomfort such as pain or a burning sensation in the affected part of the body.

      5. Sensorimotor syndrome

      The person suffering from the sensorimotor syndrome due to a lacunar infarction, suffers a mixture of symptoms of hemiparesis and hemiplegia. These symptoms include a decrease in strength on one side of the body, as well as paralysis and sensory impairment, all on the same side of the body.

        Causes and risk factors

        There are a number of diseases and conditions associated with the appearance of lacunar infarctions. Some of the most important causes are:

        Hypertension problems

        This is the most common cause. The fragility of the arteries of lacunar infarcts presents a very high risk for people with very high blood pressure.

        Diabetes

        Deterioration of the veins due to diabetes is a risk factor for a person to have one of these heart attacks.

        heart disease

        Diseases such as ischemic heart disease and atrial fibrillation are two major causes of weight loss.

        In addition, other risk factors that predispose people to have a heart attack at some point are:

        • sedentary lifestyle
        • Bad nutrition
        • High cholesterol
        • smoking
        • Consumption of alcoholic beverages
        • Drug use

        • Sleep Apnea
        • pregnancy

        Treatment and prognosis

        Emergency intervention for a person who has just suffered a lacunar infarction it increases the chances of surviving the accident and, moreover, minimizes the impact it can have.

        If detected and acted within three hours of symptom onset, anticoagulant drugs should be sufficient to improve blood flow. However, if a heart attack is more severe or takes longer to work, it will be necessary to inject the drugs directly into the affected area of ​​the brain.

        Usually, people who have suffered a lacunar infarction need general rehabilitation which includes the following aspects:

        • Physiotherapy sessions to restore motor skills
        • Neuropsychological rehabilitation to promote cognitive functions
        • Occupational therapy to facilitate the patient’s daily life

        • speech therapy in the event of damage to the tongue
        • Psychological therapy to work on the emotional aspects of the consequences of a heart attack *** Pharmacological therapy ** to eliminate the underlying causes of the lacunar accident

        Unlike other larger strokes, lacunar infarction is associated with a higher rate of recovery, with improvements within hours or days of the stroke.

        Bibliographical references:

        • Bamford, J .; Sandercock, P .; Jones, L .; Warlow, C. (1987). The Natural History of Lacunar Infarction: The Oxfordshire Community Stroke Project. Stroke. 18 (3): pages 545 to 551.
        • Grau-Olivares, M .; Arboix, A .; Bartrés-Faz, D .; Junqué, C. (2007). Neuropsychological abnormalities associated with lacunar infarction. Journal of Neurological Sciences. 257 (1-2): pages 160 to 165.
        • Sacco, S .; Marini, C .; Totaro, R .; Russo, T .; Cerone, D .; Carolei, A. (2006). “A population-based study on the incidence and prognosis of lacunar stroke.” Neurology. 66 (9): pages 1335-1338.

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