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Lacunar Stroke: What You Need to Know

by | Apr 24, 2024

Learn about lacunar stroke, a type of stroke that affects small blood vessels in the brain. Discover its symptoms, causes, and treatment options. Gain valuable insights to navigate recovery and prevention strategies effectively.

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An Introduction to Lacunar Stroke

A stroke occurs when blood flow to the brain is interrupted or changed somehow. This change can start anywhere in the body if it ultimately interferes with blood flow to the brain. Ischemic strokes happen when blood flow is blocked within the brain itself. A lacunar stroke is a type of ischemic stroke. Lacunar strokes affect the small arteries deep within the brain, occurring when the blood flow to one of these arteries is blocked. Understanding these strokes, the symptoms, risk factors, and causes is critical to prompt treatment and optimal recovery.

 

What Is a Stroke?

A stroke is a blockage prevents or interrupts blood flow to the brain. Without the oxygen and nutrients that they need, brain cells will begin to die within minutes, which is why treatment as quickly as possible is so crucial.

There are two main types of strokes:

  • Ischemic: A stroke that happens when blood flow to the brain is blocked
  • Hemmorrhagic: A stroke that occurs when there is sudden bleeding in the brain

Each of these types of strokes are then further broken down based on the specific location within the brain that the blockage or bleeding occurs. Most strokes (90%) are ischemic, while the rest are hemorrhagic, according to the National Heart, Lung, and Blood Institute.

 

Types of Ischemic Stroke 

The most common kind of stroke is the ischemic stroke, which is when blood to the brain is interrupted or stopped. Ischemic strokes can be broken down further into two types: thrombotic and embolic.

A thrombotic stroke happens when a blood clot forms inside the vessels in the brain. An embolic stroke happens when a blood clot or plaque debris forms anywhere else in the body and travels via the bloodstream to the brain, where it blocks the blood flow.

 

What Is a Lacunar Stroke? 

A lacunar stroke is a type of thrombotic stroke. Affecting the small vessels deep inside the brain, lacunar strokes can often be asymptomatic. This is because the small blood vessels result in numerous small-sized infarcts, which means small amounts of dead brain tissue. However, the asymptomatic nature of these strokes can lead to multiple areas of dead tissue, which then can cause significant cognitive and physical disabilities.

 

Stroke by the Statistics

According to the National Library of Medicine, strokes are the fifth leading cause of death. Most strokes are ischemic. Lacunar strokes are a subtype of ischemic strokes and make up approximately 25% of these strokes. Both men and women are estimated to have a similar risk of stroke, with an estimated lifetime risk of 18.3% of having an ischemic stroke.

A community-based study found that in a pre-dominantly White community, there were 29 lacunar strokes per 100,000 people. Among a pre-dominantly Black community, there were 52 lacunar strokes per 100,000 people. Studies have also found that dementia diagnoses are 4 to 12 times more common among people who have had lacunar strokes, and that the older an individual is when they have such a stroke, the greater the potential disabilities will be.

 

Symptoms of Lacunar Stroke 

Lacunar strokes can be asymptomatic, meaning there are no visible symptoms. This makes this type of stroke very dangerous. However, when there are symptoms, prompt treatment is vital to optimal recovery and minimal disability.

Harvard Medical School’s Harvard Health Publishing indicates symptoms that may occur when someone has a lacunar stroke include:

  • Difficulty walking
  • Difficulty speaking
  • Sudden numbness
  • Face, arm, leg, foot, or toe weakness or paralysis
  • Weak or paralyzed eye muscles
  • Hand or arm clumsiness
  • Other neurological symptoms

The sudden appearance of one or more of these symptoms may indicate a lacunar stroke is occurring. It is important to note that if the blood clot dissolves within minutes, the symptoms may clear up. If the clot dissolves, symptoms disappear, and the individual makes a full recovery within 24 hours, it is called a transient ischemic attack (TIA). However, if symptoms are present, the individual experiencing them or others around them should seek treatment immediately rather than waiting to see if symptoms improve.

Additional symptoms such as emotional behavior and dementia can occur if the individual suffers from untreated, prolonged high blood pressure as this can cause multiple lacunar strokes.

 

Causes of Lacunar Stroke

The cause of lacunar strokes is a blockage of the small blood vessels in the brain. This is often by a blood clot, but can also be due to a narrowing of the arteries which makes them easier to block. The arteries can be blocked by plaque formation, which are deposits of fat and other substances that may build up in the arteries.

There are several risk factors that can cause artery thickening or blood clots.

 

Risk Factors of Lacunar Stroke

The National Library of Medicine indicates that three risk factors for lacunar strokes are:

Other factors that increase the risk of having a stroke include:

  • Age
  • Gender
  • Genetic predisposition
  • Obesity
  • High cholesterol
  • Excessive alcohol consumption

 

Diagnosis of Lacunar Stroke

Whenever someone has a stroke, emergency treatment is needed to limit or prevent damage. If you suspect that you or someone else is having a stroke, immediately call emergency services.

If the symptoms are consistent with a stroke, doctors may order a computerized tomography  (CT) scan which takes detailed images of the brain. Because lacunar strokes are so small and deep within the brain, a CT scan may not show them clearly. A magnetic resonance imaging  (MRI) may be ordered as well as a CT angiography.

Other common diagnostic tests include checking the individual’s blood pressure, a detailed neurological exam, kidney and liver function tests, a variety of blood tests, and heart function tests such as electrocardiograms and echocardiograms.

 

What to Do When Experiencing Lacunar Stroke

If you or someone else seems to be experiencing symptoms of a lacunar stroke, it’s crucial to seek immediate medical attention. Time is of the essence in treating strokes, as prompt intervention can minimize potential damage and improve outcomes. Call emergency services or go to the nearest hospital without delay. While waiting for medical assistance, staying calm and trying to keep the affected person comfortable is essential. Avoid giving them anything to eat or drink until they are evaluated by medical professionals. Providing detailed information about the onset and progression of symptoms to the healthcare team can aid in accurate diagnosis and appropriate treatment.

 

Importance of Prompt Recognition

Undiagnosed and untreated strokes can cause significant damage to the brain, leading to lasting disabilities such as paralysis, short-term memory loss, numbness, loss of muscle control on one side of the body, difficulty thinking and reasoning, and controlling emotions. It can also cause depression.

The quicker an individual is diagnosed and treated for stroke symptoms, the better their chances of recovering with fewer lingering problems. Additionally, each stroke an individual has increases the chances of future strokes, which increases the possibility of brain damage and disabilities. Being able to quickly recognize the symptoms of a potential stroke reduces the time it takes to see a doctor, get diagnosed, and begin treatment.

 

Diagnosis and Treatment Options at a Specialized Stroke Clinic and Stroke Specialist in Singapore

While quick treatment is important, a specialized stroke clinic and a stroke specialist can provide additional diagnosis and treatment options based on your risk factors, previous stroke history, and other factors. If there is one near you when you suspect a lacunar stroke, you can ask emergency services to take you there instead of the emergency room.

However, a specialized stroke clinic and a stroke specialist can still be beneficial after receiving initial treatment at the emergency room. A few of the state of the art therapies that you may be treated with at a stroke clinic include:

  • Minimally invasive thrombectomies
  • Implanted pellets, brain glue, or coils
  • Repair of abnormal intracranial blood vessels
  • Cerebrovascular blood clot removal
  • Intracranial stenting

A stroke specialist can do more than diagnose and treat you after a stroke. They can also offer stroke screenings, including a consultation, blood tests, and CT scans and MRIs of the brain and its blood vessels. After screening, you’ll get personalized advice on reducing your stroke risk based on your unique screening results.

High risk patients can receive additional testing as part of their screening, including an ultrasound or magnetic resonance angiography. A stroke specialist may also be able to assist you in managing risk factors to help reduce or prevent a lacunar stroke.

 

When to see a Stroke Specialist

A stroke doctor is also sometimes called a vascular neurologist. They can assist with care after a stroke as well as preventive care. You should see a stroke specialist if:

  • You have had one or more strokes
  • You have one or more risk factors for having a stroke
  • You are having difficulty recovering from a stroke

 

How to Reduce and Prevent Lacunar Stroke

While there are no guarantees, there are things you can do to reduce the risk and possibly prevent strokes. One of the most important things you can do is manage the risk factors for stroke. For example, if you have high blood pressure or diabetes, working with your primary doctor to get the condition under control can reduce your risk of a stroke.

Regular exercise is also shown to help reduce the risk of having a lacunar stroke, according to the National Library of Medicine. If you have a family history of lacunar strokes, or strokes in general, you may want to speak with a stroke specialist to learn more about specific things you can do to try to prevent a lacunar stroke.

 

Learn Your Stroke Risk and Protect Yourself

Having a proper stroke plan, understanding the risk factors and treatment options, and finding the right stroke doctor can all help you reduce the risk of a lacunar stroke and give you the best chances of a full recovery in the event that you do have a stroke. A stroke specialist can give proper care (including surgery) to improve the quality of your life and treat your stroke health and stroke-prevention related issues. With a proper diagnosis, quick and effective care, and personalized treatment, a stroke doesn’t have to have a lasting impact on your life. Contact Supreme Vascular today to meet with our stroke specialist and get started on ensuring your stroke health.

Ischemic Stroke Guide

Four in five strokes are ischemic. They are caused by lack of blood flow to the brain. it’s very important to follow prevention plans and avoid ischemic stroke causes in the future. 

Consult a Stroke Specialist in Singapore

Dr. Manish Taneja, is an expert in endovascular and image guided neurointerventional procedures of brain and spine. He has special interest in treatment of brain aneurysms, stroke and vascular malformations. Come in for a further evaluation and arrange an appointment today with our stroke specialist.

 

Dr. Manish Taneja performing surgery

Stroke Resources

Stroke in Younger Adults: What You Need to Know

Most experts consider young stroke to pertain to individuals under the age of 45. Today, there is a growing trend of younger and middle-aged adults suffering from stroke. 

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We’ve Got You Covered for Specialized Stroke Screening, Prevention, and Management

Imagine heart attacks where the blood flow to your heart is blocked. Similarly, a stroke occurs when the blood flow to your brain is interrupted becoming a “brain attack”. When blood supply does not reach a certain part, brain cells begin to die. Different types of stroke include ischemic strokes (blockage of blood vessel due to blood clot) or a mini stroke, a TIA (transient ischemic attack), with no permanent damage yet serious. Stroke also occurs when a blood vessel in the brain pops causing bleeding in the brain.

Certain areas of the brain can be affected by stroke and some symptoms of a stroke including cardiovascular disease, diabetes, and high blood sugar levels increase the risk of stroke whereas an active lifestyle or controlling high cholesterol reduces the risk. How well do you know stroke? Find tips to prevent and manage stroke, the differences in stroke screening tests, and the newer technology and treatments available. Come in for an easy consultation and further evaluation with our stroke specialist in Singapore at the Supreme Vascular and Interventional Clinic. 

Supreme Vascular and Interventional Stroke Programs

Brain Aneurysm Resources

Discover brain aneurysm resources that go beyond the basics designed for patients. Understand the meaning of  a brain aneurysm condition, the causes, symptoms, signs, and more. Connect with your brain health.

Put Brain Aneurysm on Your Health Radar

Did you experience the worst headache of your life? Could it be a brain aneurysm that ruptures, which means bleeding in the brain? Thoughts could be racing through your mind. Then what is the difference between unruptured (a weak or thin spot on an artery in the brain that balloons) or ruptured brain aneurysm? If you’re wondering, then the Supreme Vascular and Interventional Clinic is here to help. It’s important to look out for the tell-tale brain aneurysm symptoms, signs, causes, and risk factors.

Dr. Manish Taneja has been performing brain aneurysm treatments since 1995 from surgical clipping to latest minimally invasive procedures. Each patient is unique as is the size and location of the aneurysm. Your brain has different conditions to treat the aneurysm and artery vessel walls of a blood vessel in the brain. This calls for personalised brain aneurysm treatment depending on your symptoms, family, history, medication, and more. A simple CT scan could be just what the doctor ordered and the first step in early detection and prevention of a brain aneurysm. Come in for an easy consultation with our brain aneurysm specialist in Singapore to be on your health radar.

Other Health Conditions

The Supreme Vascular and Interventional Clinic is your “go-to” facility for various neurological conditions and treatments. To arrange an appointment with Dr. Manish Taneja, our neurointervention specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.