What is a lacunar stroke?
A stroke occurs when blood flow to the brain is interrupted or blocked. Strokes that are caused by blockages in blood vessels within the brain are called ischemic strokes. Lacunar stroke is a type of ischemic stroke that occurs when blood flow to one of the small arteries deep within the brain becomes blocked.
According to the National Institutes of Health (NIH), lacunar strokes represent about one-fifth of all strokes. Any type of stroke is dangerous because brain cells are deprived of oxygen and begin to die within minutes.
What are the symptoms of a lacunar stroke?
Symptoms of stroke usually come on suddenly and without warning. Signs of a lacunar stroke can include:
- slurred speech
- inability to raise one arm
- drooping on one side of the face
- numbness, often on only one side of the body
- difficulty walking or moving your arms
- memory problems
- difficulty speaking or understanding spoken language
- loss of consciousness or coma
As brain cells die, functions controlled by that area of the brain are affected. These symptoms can vary depending on the location of the stroke.
What causes a lacunar stroke?
Lacunar stroke is caused by a lack of blood flow in smaller arteries that supply deep brain structures. The most important risk factor for the development of lacunar stroke is chronic high blood pressure. The condition can cause the arteries to narrow. This makes it easier for cholesterol plaques or blood clots to block blood flow to the deep brain tissues.
Who is at risk for lacunar stroke?
The risk of lacunar stroke increases with age. Those at risk include people with chronic high blood pressure, heart disorders, or diabetes. African-Americans, Hispanics, and people with a family history of stroke are also at a higher risk than other groups.
Additional factors that increase the likelihood of lacunar stroke include:
- smoking or exposure to secondhand smoke
- alcohol use
- drug abuse
- use of birth control pills
- sedentary lifestyle
- poor diet
- high cholesterol
- obstructive sleep apnea
It’s important to have annual physical examinations to screen for health issues that could raise your risk for stroke, including high cholesterol and obstructive sleep apnea.
How is a lacunar stroke diagnosed?
Emergency treatment is necessary for any type of stroke, so it’s imperative to seek diagnosis immediately. Your doctor may take your blood pressure and ask about your symptoms. A detailed neurological exam will be used to see if there is any damage to the parts of the brain that control your bodily functions.
If your symptoms are consistent with stroke, immediate diagnostic testing will likely include a CT scan or a MRI scan to take detailed images of your brain. A Doppler ultrasound may also be used. This will measure the amount of blood flowing through your arteries and veins.
Heart function tests, such as electrocardiogram and echocardiogram may be ordered. Kidney and liver function testing and various blood tests may also be administered.
What is the treatment for lacunar stroke?
If you have a lacunar stroke, early treatment increases your chance of survival and may prevent further damage. Once you arrive at the emergency room, you’ll likely be given aspirin and other medications. This reduces your risk of having another stroke.
Supportive measures may be needed to assist your breathing and heart function. You may receive intravenous clot-busting drugs. In extreme circumstances, a doctor can deliver medications directly into the brain.
Lacunar stroke can result in some brain damage. Depending on how badly the underlying structures are damaged, you may not be able to care for yourself following a stroke. Recovery varies for each person and depends on the severity of the stroke.
Some people who experience a lacunar stroke transition from the hospital to a rehabilitation center or nursing home, at least for a short period of time. Because of brain damage, stroke patients often have to relearn skills and regain their strength. This can take weeks, months, or years.
Most people who experience a stroke require long-term treatment. This can include medication to treat high blood pressure, diabetes, or high cholesterol. After a lacunar stroke, some people also require:
- physical therapy to restore function
- occupational therapy to improve skills needed for everyday living
- speech therapy to improve language skills
What is the long-term outlook?
Quality of life after lacunar stroke depends on many factors, including age and how quickly treatment began after symptoms started. For some patients, disabilities are permanent. These can include:
- loss of muscle control on one side of the body
- tingling sensation in the affected limb
Even after rehabilitation and stroke recovery, some stroke survivors have problems with short-term memory. Some may also have difficulty with thinking and reasoning. Controlling your emotions can also be an issue. Some stroke survivors also deal with depression.
Having a lacunar stroke increases your risk of subsequent strokes, so regular medical care is very important.
According to the American Stroke Association, although the incidence of stroke is higher in men, women represent more than half of stroke deaths across all age groups.
Lower your risk
Lacunar stroke is a life-threatening emergency. Some risk factors such as aging and family history are beyond your control, but certain lifestyle behaviors can influence risk. Maintain a healthy diet. Exercise regularly for at least 30 minutes most days of the week. Together, these habits can help lower your risk of having a lacunar stroke.
If you have high blood pressure, heart disease, or diabetes, strive to keep it under control and see your doctor regularly. Don’t smoke. And most importantly, seek medical attention at the first sign of stroke — every second matter.