Presentation
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]
In deep brain gray matter or brainstem lacunar infarctions, early neurological recovery was less likely when headache was present. [headachejournal.onlinelibrary.wiley.com]
There is at present no evidence to suggest that embolism plays any important role in these disorders. [ahajournals.org]
Eyes
- Vertical Gaze Palsy
Eye movement disorders with or without hemiparesis, including cranial nerve (CN) III, vertical gaze palsy, and internuclear ophthalmoplegia, as the result of small deep infarcts, have been described. [emedicine.medscape.com]
Neurologic
- Stroke
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]
Dysarthria – Presents with dysarthria and weakness of the hand, which is more pronounced when writing, for example. [xpertdox.com]
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. [stroke.about.com]
- Focal Neurological Deficit
A TIA is a focal neurological deficit that lasts less than 24 hours and resolves. The mechanism of TIAs is uncertain. [neuropathology-web.org]
Disorders and Stroke (NINDS). [18] In particular, lacunar infarct was defined as a focal neurological deficit involving the carotid or vertebrobasilar territory which lasted for more than 24 hours and consisted of one of the following syndromes: pure [neurologyindia.com]
An ischemic condition of the brain, producing a persistent focal neurological deficit in the area of distribution of the cerebral arteries. In medicine, a loss of blood flow to part of the brain, which damages brain tissue. [icd10data.com]
- Hemichorea
Acute hemichorea-hemiballism is most frequently caused by lacunar infarcts in the basal ganglia contralateral to the dyskinesia. [ncbi.nlm.nih.gov]
[…] lacunar syndrome, such as pure dysarthria �Cpartial form of dysarthria-clumsy hand syndrome-, or as isolated dysarthria-facial paresis syndrome �Cpartial or frustrated form of pure motor hemiparesis- or also as an uncommon neurological syndrome such as hemichorea-hemiballismus [ghrnet.org]
[…] and in the junction between the capsule and corona radiata. [43] Other etiologies causing this syndrome include pontine [79] and putaminal hemorrhage. [56] Overall, the prognosis is favorable. [11] Other Lacunar Syndromes Movement disorders, including hemichorea-hemiballism [emedicine.medscape.com]
- Thalamic Pain
Probably unique in the present case is the demonstration of bilateral thalamic pain secondary to two almost identical thalamic infarcts. Small vessel disease (microatheroma or lipohyalinosis) was the most likely cause of the lacunes. [jmedicalcasereports.com]
Sensory loss extends over the entire side of the body, splitting it almost exactly in the midline, which appears to be a characteristic of thalamic and thalamocortical pathway lesions. [5, 6, 36] Dysesthetic symptoms, as in the classic thalamic pain syndrome [emedicine.medscape.com]
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]
Colonoscopy
- Colitis
Abstract We present the case of a young man who experienced a sudden onset of pure motor hemiplegia in association with ulcerative colitis. [ncbi.nlm.nih.gov]
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]
Lacunar Infarct Treatment and Management The treatment depends on the severity of the symptoms and the duration of the disorder. [hxbenefit.com]
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]
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]
CONCLUSION: Both WML and LI were associated with retinal microvascular signs, supporting a microvascular etiology. [ncbi.nlm.nih.gov]
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]
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]
Lacunar Infarct Epidemiology These strokes are believed to responsible for around 25% of the total cases of ischemic strokes. Fifteen out every 100,000 people are affected by this condition every year. Men are more prone to it compared to women. [hxbenefit.com]
Pathophysiology
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]
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]
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]