Presentation
No cortical findings are present. • Dysarthria-Clumsy Hand Usually involves the pons or internal capsule; presents clinically with dysarthria, dysphagia, contralateral facial paresis and tongue weakness, contralateral paresis/clumsiness of the arm and [casemed.case.edu]
BACKGROUND: The aim of the present study was to investigate whether there were differences in neuroradiological features, including white-matter lesions and gray-matter volumes, between patients with lacunar infarction with and without mild cognitive [ncbi.nlm.nih.gov]
Case presentation A 48-year-old Caucasian woman with insulin-dependent diabetes and hyperlipidemia experienced symptoms that progressed within hours to a complete left-sided hemisensory syndrome. [jmedicalcasereports.com]
In deep brain gray matter or brainstem lacunar infarctions, early neurological recovery was less likely when headache was present. [headachejournal.onlinelibrary.wiley.com]
Entire Body System
- Disability
Good outcome was designated as a modified Rankin disability scale 0-2 at discharge in phenylephrine group. [ncbi.nlm.nih.gov]
Otherwise, sensory impairment did not cause disability or handicap. [stroke.ahajournals.org]
Stroke is a leading cause of death and disability and rapid treatment is essential to minimise damage to the brain and reduce the risk of prolonged disability. [news-medical.net]
- Anemia
[…] calcification, left atrial turbulence, nonbacterial endocarditis, congestive heart failure, recent myocardial infarction (within 4 weeks) Bleeding diathesis Chronic liver disease (ALT > 100 or AST > 100) or chronic renal disease (creatinine > 3.0mg/dl) Anemia [clinicaltrials.gov]
Sickle cell anemia, Fabry disease, and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) are caused by single gene defects associated with ICVD ( 6 – 8 ). [spandidos-publications.com]
Those patients have a disturbed biochemical state and multi-organ complications, such as accelerated calcific atherosclerosis, platelet dysfunction, and anemia[ 41 ]. This inclusion criteria may cause certain selection bias to our study. [journals.plos.org]
Any factor that impairs systemic perfusion (eg, carbon monoxide toxicity, severe anemia or hypoxia, polycythemia, hypotension) increases risk of all types of ischemic strokes. [msdmanuals.com]
[…] vascular protection. 39 Inflammatory and procoagulant pathways and asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide synthase, might be important mediators leading to the increased cardiovascular risks of patients with CKD. 40, 41 Anemia [nature.com]
- Fatigue
M.D. 33,633 satisfied customers I have been experiencing pain/fatigue issues for some time, I have been experiencing pain/fatigue issues for some time, which eventually led to a brain MRI. [justanswer.com]
Inventory (MFI-20) [ Time Frame: at baseline, 3 (primary analysis), 6 and 12 months after baseline testing ] A 20-item self-report instrument designed to measure fatigue. [clinicaltrials.gov]
Skeleton muscle movement become dawdling due to severe fatigue. Ability to speak may diminish or speech difficulty arises, but without affecting intellectual capacity. Dysphagia due to problematic tongue movement. [healthsaline.com]
- Fever
Controlling hyperglycemia and fever can limit brain damage after stroke, leading to better functional outcomes. Long-term management also focuses on prevention of recurrent stroke (secondary prevention). [msdmanuals.com]
- Malnutrition
Early assessment of a patient with swallowing problems may prevent dehydration and malnutrition from inadequate intake, as well as prevent aspiration and pneumonia. [emedicine.medscape.com]
Gastrointestinal
- Dysphagia
Contralateral hemisensory loss of face, arm, leg Sensory-Motor Stroke Affects Thalamus, Internal Capsule or Putamen -capsule-caudate Ipsilateral sensory and motor loss of the face, arm, leg Clumsy Hand Dysarthria Affects pons or Internal Capsule Dysarthria and Dysphagia [fpnotebook.com]
• Dysarthria-Clumsy Hand Usually involves the pons or internal capsule; presents clinically with dysarthria, dysphagia, contralateral facial paresis and tongue weakness, contralateral paresis/clumsiness of the arm and hand. • Sensory-motor stroke Typically [casemed.case.edu]
Dysphagia due to problematic tongue movement. Frequent fall down due to reduced body balancing capacity Discomfited walking style occurs due to numbness in the feet. [healthsaline.com]
Problems with swallowing (dysphagia) and difficulty in pronouncing words can be present (dysarthria). PMS occurs in 33 to 50% of lacunar infarcts. Pure Sensory Syndrom (PSS). [braininjury-explanation.com]
Dysarthria, dysphagia, and transient sensory symptoms may also be present. [en.wikipedia.org]
Cardiovascular
- Heart Failure
Failure in Seniors ACG Issues Guideline for Management of Upper GI Bleeding American College of Cardiology, May 15-17 View All News > View All News > PROCEDURES The Vaginal Exam in Labor Uterine Compression Uterine Balloon Tamponade View All Procedures [msdmanuals.com]
failure, recent myocardial infarction (within 4 weeks) Bleeding diathesis Chronic liver disease (ALT > 100 or AST > 100) or chronic renal disease (creatinine > 3.0mg/dl) Anemia (hemoglobin < 10mg/dl) or thrombocytopenia (platelet count less than 100,000 [clinicaltrials.gov]
Causes of death were myocardial infarction (2 patients), stroke, heart failure, and malignancy (1 patient each). [stroke.ahajournals.org]
Coronary heart disease, myocardial infarction, congestive heart failure, stroke, TIA, claudication, hypertension, and diabetes were defined using patients' reports, hospital and clinic records, and data collected as part of the CHS study. [jamanetwork.com]
Skin
- Formication
The dried iTRAQ-labeled peptides were reconstituted in 200 µl of Buffer A (10 mM NH 4 HCO 2, 85% ACN, 0.1% formic acid (FA)) and fractionated using a PolyWAX LP column (200 × 4.6 mm; 5 µm; 300 Å) (PolyLC, Columbia, MD, USA) on a Prominence HPLC system [journals.plos.org]
- Flushing
A saline flush was administered between the acquisition of CTA and CTP imaging, but not between the 2 CTP acquisitions. [ajnr.org]
Neurologic
- Stroke
[…] and how to manage an onset of stroke. [en.wikipedia.org]
[…] with lacunar strokes. [emedicine.medscape.com]
Subtypes of lacunar syndromes included pure motor stroke in 63 patients, sensorimotor stroke in 51, pure sensory stroke in 14, atypical lacunar syndrome in 9, ataxic hemiparesis in 5 and dysarthria-clumsy hand in 4. [ncbi.nlm.nih.gov]
- Dysarthria
Patients with dysarthria-clumsy hand/ataxic hemiparesis accounted for the best scores in some tests of visuoconstructive function and visual memory. [ncbi.nlm.nih.gov]
No cortical findings are present. • Dysarthria-Clumsy Hand Usually involves the pons or internal capsule; presents clinically with dysarthria, dysphagia, contralateral facial paresis and tongue weakness, contralateral paresis/clumsiness of the arm and [casemed.case.edu]
Affects pons or Internal Capsule Dysarthria and Dysphagia Contralateral arm and hand clumsiness (dysmetria, weakness, dysdiadochokinesis) Contralateral facial paresis and Tongue weakness [fpnotebook.com]
Dysarthria Clumsy-Hand Syndrome By definition, dysarthria clumsy-hand syndrome is a combination of symptoms caused by a lacunar stroke affecting the anterior portion of the internal capsule. [verywellhealth.com]
Dysarthria, dysphagia, and transient sensory symptoms may also be present. [en.wikipedia.org]
- Clumsiness
Patients with dysarthria-clumsy hand/ataxic hemiparesis accounted for the best scores in some tests of visuoconstructive function and visual memory. [ncbi.nlm.nih.gov]
• Dysarthria-Clumsy Hand Usually involves the pons or internal capsule; presents clinically with dysarthria, dysphagia, contralateral facial paresis and tongue weakness, contralateral paresis/clumsiness of the arm and hand. • Sensory-motor stroke Typically [casemed.case.edu]
[…] peduncle The main symptoms are dysarthria and clumsiness (i.e., weakness) of the hand, which often are most prominent when the patient is writing. [en.wikipedia.org]
Hand Dysarthria Affects pons or Internal Capsule Dysarthria and Dysphagia Contralateral arm and hand clumsiness (dysmetria, weakness, dysdiadochokinesis) Contralateral facial paresis and Tongue weakness [fpnotebook.com]
- Tingling
At times there may be abnormal sensations like tingling, numbness in one hand or one half of body. [newtimes.co.rw]
Sometimes these patients will have numbness or tingling early in the course of the stroke, but this usually passes relatively quickly, while the motor deficits can take months or years to resolve. [lacunarinfarct.net]
Second most common syndrome Weakness and clumsiness on one side of body; legs affected more commonly than arms Dysarthria/Clumsy hand Facial weakness Severe dysarthria Slight weakness and clumsy hand Pure sensory stroke (Thalamus) Persistent numbness or tingling [usmleforum.com]
Pure sensory stroke syndrome causes tingling, numbness, or other unusual sensations on the affected side of the body. [wisegeek.com]
Pure sensory stroke – Presents only with sensory changes such as tingling, burning, or unusual sensations of the affected areas of the body. Mixed sensorimotor stroke – Hemiparesis or hemiplegia together with sensory involvement. [xpertdox.com]
- Neglect
Remember that lacunar strokes are NOT associated with cortical findings, such as aphasia (except rarely), apraxia, neglect, or visual field abnormalities. [casemed.case.edu]
Intracranial branch atheromatous disease: a neglected, understudied, and underused concept. Neurology 1989;39:1246-1250. PMID: 2671793. 12. Yoon Y, Lee DH, Kang DW, Kwon SU, Kim JS. [j-stroke.org]
The presence of these cortical signs may exclude an internal capsule stroke: gaze preference or gaze deviation expressive or receptive aphasia visual field deficits visual or spatial neglect If any of these signs are present, the patient may have a cortical [stanfordmedicine25.stanford.edu]
Workup
His symptoms settled with treatment of the polycythemia and workup did not find another cause of ischemic stroke. [karger.com]
A post hoc analysis 4 of the National Institute of Neurological Disorders and Stroke trials considered final causative mechanisms of stroke assigned by local investigators after the diagnostic workup and also showed no effect modification. [jamanetwork.com]
Cardiac workup of ischemic stroke. Curr Cardiol Rev 2010;6:175-183. [PMID: 21804776] 14. [ghrnet.org]
This knowledge leads researchers to believe that complete workups of SDIs are critical to identifying potential cardioembolic and arterial causes of strokes. [4] Definition of lacunes Lacunes may be defined as small subcortical infarcts (< 15 mm in diameter [emedicine.medscape.com]
Treatment
Induced-hypertension using phenylephrine was applied to 52 patients and the others received conventional treatment. [ncbi.nlm.nih.gov]
The analysis of treatment response demonstrated a significant benefit of treatment with alteplase observed in 36% (n=19) of patients in the alteplase group compared with 14% (n=7) of patients in the placebo group ( P =.009). [neurologylive.com]
Thus, acute therapy with rtPA may be regarded as an effective treatment option in this stroke subtype. [journals.plos.org]
Early treatment also prevents any further damage to the brain. The first line of treatment is to give aspirin to minimize risk of having another infarct. [epainassist.com]
Prognosis
Despite having an excellent recovery during acute phase, certain LACI patients have poor mid- to long-term prognosis due to the recurrence of vascular events or a decline in cognitive functions. [ncbi.nlm.nih.gov]
Our present results add evidence to the idea of 2 different lacunar stroke types because prognosis differed between the 2 groups, with a more unfavorable prognosis for the patients with ≥1 silent lesions on CT. [ahajournals.org]
Etiology
[…] and multiple possible etiologies [5,6] Another method of classification is modified Oxfordshire method, based on the anatomic distribution of infarcts-- total anterior circulation infarcts, partial anterior circulation infarcts, posterior circulation [acronymfinder.com]
Recent advances in neuroimaging help us to better visualize lesions with relevance to actual clinical syndromes and with respect to functional systems thus leading to earlier and more accurate etiologic diagnosis and refinement of clinico-anatomical correlations [eurekaselect.com]
CONCLUSION: Both WML and LI were associated with retinal microvascular signs, supporting a microvascular etiology. [ncbi.nlm.nih.gov]
PURE MOTOR STROKE OF UNUSUAL ETIOLOGY PMS and the other lacunar strokes may be caused in less than 5% of cases by other etiologies, mainly hematological diseases and infectious or inflammatory arteritis[ 4, 5, 18 ]. [wjgnet.com]
Epidemiology
BACKGROUND AND PURPOSE: On brain imaging, lacunes, or cerebrospinal fluid-containing cavities, are common and are often counted in epidemiological studies as old lacunar infarcts. [ncbi.nlm.nih.gov]
Epidemiology The yearly incidence of lacunar infarcts is around 15 cases per 100,000 people, and it’s estimated that these infarcts account for 25 percent of all cases of ischemic strokes. [xpertdox.com]
Epidemiology One community-based study in Rochester, MN estimated that around 16% of first ischemic strokes in the United States are lacunar strokes. [5] In a similar community-based study of African-Americans in Cincinnati, lacunar infarctions accounted [statpearls.com]
Continuing follow-up with a physician is essential so that the physician may monitor medication dosage and risk factors. [8] Epidemiology [ edit ] It is estimated that lacunar infarcts account for 25% of all ischemic strokes, with an annual incidence [en.wikipedia.org]
Pathophysiology
A SLI or any type of silent stroke places an individual at greater risk for future major stroke. [2] [3] Pathophysiology [ edit ] Small arteries beneath brain. [en.wikipedia.org]
To investigate the pathophysiological characteristics of a case of progressive lacunar infarction using diffusion-weighted and conventional magnetic resonance imaging (MRI) scans. [ncbi.nlm.nih.gov]
Prevention
If bedridden, family should keep him dry and turn him frequently to prevent bed sores. A healthy life style from an early age can very well prevent any type of stroke including lacunar infarcts. [newtimes.co.rw]
CONCLUSION: Bedside neurological assessment and MRI findings may allow us to predict PS and start early intensive treatment for preventing further neurological deterioration. 2008 S. Karger AG, Basel. [ncbi.nlm.nih.gov]
This may help in prevention of development of further complications. To prevent the further attack, blood pressure management is an important factor for hypertensive patient. [healthsaline.com]
Stroke prevention is like heart attack prevention. Patients should care for their cardiovascular health through weight control, blood pressure control, control of diabetes, and living in a healthy way. [neurology.org]