Lacunar stroke is one of the varieties
The essence of the disease
With the development of this type of stroke, the pathological changes observed in the perforating blood vessels, that relate to structures of small diameter. The characteristic pathologic feature of this type of stroke is the formation of a small cavity formations in the brain are gaps. Is a rounded or irregular shape formation with a diameter of 1 mm or less, up to 2O mm. Gaps of size 15-2O mm are rare, they belong to a giant.
The term “lacuna” which means a lake, a cavity in a medical practice first introduced in 1843 Vandal who discovered such formations in the brain of elderly patients in life, suffering from hypertension. In 1965, Fisher described the clinical symptoms of lacunar stroke as a manifestation of hypertensive encephalopathy.
Despite the long history of the study of this type of circulatory disorders in the brain, this pathological state is saved among modern researchers because of the high prevalence of the disease among the population.
Localization of foci of damage in the brain:
- the white part of the brain tissue, the basal ganglia, internal capsule and thalamus (80% of localizations);
- the cerebellum and the bridge of the brain (20% of localizations).
This type of ischemic brain damage never hurt the bark of the hemispheres, and associated features and symptoms of the disease.
As has been said, lacunar infarct occurs in lesions of the perforating arteries, which are previously subject to pathological changes due to hypertension. It fibrinoid necrosis, hyalinosis of the vascular wall, deposition of lipid formations, the occurrence of plasmorrhea, substitution of elastic and muscular elements of the arterial wall connective tissue elements.
Due to the described pathological changes is the narrowing and occlusion of the perforating arteries that foresees the development of infarction of brain tissue, which provides blood from this vessel.
It is important to know! Very often lacunar strokes are “silent”, meaning they do not manifest clinically. Contrary to popular but incorrect opinion, this is a poor prognostic sign, because, as a rule, such multiple heart attacks and do not lead to neurological deficits, development of severe dementia and various cognitive disorders.
Causes of lacunar stroke
As has been said, lacunar stroke is associated with arterial hypertension and pathological changes of cerebral vessels in this disease. But some researchers in the pathogenesis of the developmentthis type of brain ischemia isolated and the contribution of atherosclerotic vascular lesions.
Risk factors for lacunar stroke:
The symptoms of lacunar cerebral infarction
This type of infarction of brain tissue clinically occurs in the form of transient ischemic attack or
Complications and prognosis
The prognosis for isolated lacunar stroke favorable. Usually the resumption of all functions, there are sometimes partial residual motor or sensitive symptoms.
If lacunar stroke often recurs, the possibility of development of such complications, as a lacunar state of the brain. Among patients with vascular dementia this complication is found in almost 65-70% of cases.
As a rule, suspected lacunar stroke is possible, leaving the history of the patient (hypertension, diabetes mellitus and other risk factors), clinical features of diseases, which are described above. But it may occur some other
Principles of treatment
Treatment of lacunar stroke differs from an ischemic. Mainly used only basic therapy, the differentiated treatment (thrombolysis) does not apply, as there is no need.
Principles of treatment of lacunar stroke:
- adequate therapy of the underlying disease (hypertension, atherosclerosis, vasculitis, diabetes mellitus);
- improvement of cerebral circulation;
- the use of neuroprotective and metabolic drugs.
Video transmission about the types of stroke:
Special attention should be devoted to the rehabilitation phase after a stroke, as complete a rehabilitation program will fully get rid of neurological disorders. It is also important not to forget about prevention of recurrent lacunar infarctions and, consequently, vascular dementia.