Lacunar Infarction: Causes, Symptoms And Treatment
Cerebrovascular accidents (CVA) They consist of an interruption of the flow of blood sent to the brain due to various causes. When this flow is paralyzed, the brain stops feeding on oxygen and nutrients, which leads to damage or death of brain cells in a specific area of ​​the brain.
But there are different types of strokes, usually these attacks damage the brain tissue in the outermost or superficial area of ​​the brain. However, When this damage occurs in the most internal structures of the brain, it is called a lacunar infarction We will talk about this type of alteration in the following lines.
Lacunar infarction refers to a type of stroke in which one of the arteries that supply blood to the internal structures of the brain becomes blocked leaving the brain without the supply of oxygen and nutrients necessary for it to function.
The arteries susceptible to damage in a lacunar infarction are smaller and therefore more fragile than the rest; they come directly from a main artery which transports blood under high pressure.
When a person suffers a lacunar infarction, cells in a relatively limited area of ​​the brain begin to damage or die due to lack of oxygen. Taking into account that a large number of internal brain structures cooperate in the communication and coordination of body movements, a lacunar infarction can pose a significant risk of causing disability.
Compared to other types of strokes, lacunar infarctions represent 20% of the cerebral infarctions suffered by people.
Symptoms of lacunar infarction
Since different brain areas control various functions such as movement, vision, speech, etc., the symptoms that alert a person that they are suffering from a lacunar infarction will depend on the area of ​​the brain that is being damaged. These symptoms include:
If a person suffering from high blood pressure does not receive any type of treatment, it is very likely that they will suffer a series of lacunar infarctions that lead to the appearance of additional symptoms such as dementia or emotional behavior.
Likewise, if the person perceives one or more of the above symptoms they should be alert, since this could also mean that they are about to suffer a more serious cardiovascular accident.
Types of lacunar syndromes
As mentioned above, both symptoms and consequences can vary depending on the area of ​​the brain affected by lacunar infarction.
There are five main lacunar syndromes, out of a list of approximately 85. These are as follows.
1. Pure motor syndrome
In this type of lacunar accident, the person experiences paralysis or a decrease in muscular vigor that equally affects an entire side of the body. This paralysis is called hemiparesis and affects approximately 50% of people who have suffered a lacunar infarction.
2. Ataxic hemiparesis
This consequence is characterized by partial paralysis, or paresis, of varying severity and great difficulty in coordinating movements or ataxia, of the extremities, with the legs being affected more often than the arms.
In this case the person suffers a decrease in the dexterity and precision of hand movements. Besides, This deficit is accompanied by difficulties articulating sounds or words caused by facial muscle weakness or paralysis, also known as dysarthria.
4. Pure sensory syndrome
In pure sensory syndrome the person experiences a continuous or temporary numbness on one side of the body Likewise, you may suffer alterations in sensitivity that cause discomfort such as pain or a burning sensation in the affected part of the body.
5. Sensory-motor syndrome
The person who suffers sensory-motor syndrome due to a lacunar infarction suffers from a mixture of symptoms of hemiparesis and hemiplegia These symptoms include a loss of strength on one side of the body, along with paralysis and sensory disturbance, all on the same side of the body.
Causes and risk factors
There are a series of diseases and conditions associated with the appearance of lacunar infarctions. Some of the most significant causes are:
Hypertension problems
It is the most common cause. The fragility of the arteries of lacunar infarctions carry a very high risk for people with very high blood pressure.
Diabetes
The deterioration of the veins due to diabetes is a risk factor for the person to suffer one of these heart attacks.
Heart conditions
Diseases such as ischemic heart disease and atrial fibrillation are two major causes of suffering from a lacunar infarction.
In addition, other risk factors that predispose people to suffer a lacunar infarction at some point are:
Treatment and prognosis
An emergency intervention in a person who has just suffered a lacunar infarction increases the chances of surviving the accident and, in addition, of minimizing the impact it may have.
If detected and intervened within three hours of the onset of symptoms, anticoagulant drugs should be sufficient to improve blood circulation. However, if the infarction is more serious or takes longer to act, it will be necessary to inject the drugs directly into the affected area of ​​the brain.
Usually, people who have suffered a lacunar infarction require general rehabilitation which includes the following aspects:
Physiotherapy sessions to restore motor skills
Neuropsychological rehabilitation to promote cognitive functions
Occupational therapy to facilitate the patient’s daily life
Speech therapy intervention in the event that there is damage to the language
Psychological therapy to work on the emotional aspects of the consequences of the heart attack *** Pharmacological therapy ** to eliminate the underlying causes of the lacunar accident
Unlike other larger strokes, lacunar infarction is associated with a higher rate of recovery, presenting improvements in the hours or days following the infarction.
Bamford, J.; Sandercock, P.; Jones, L.; Warlow, C. (1987). The natural history of lacunar infarction: The Oxfordshire Community Stroke Project. Stroke. 18 (3): pp. 545 – 551.
Sacco, S.; Marini, C.; Totaro, R.; Russo, T.; Cerone, D.; Carolei, A. (2006). “A population-based study of the incidence and prognosis of lacunar stroke.” Neurology. 66 (9): pp. 1335 – 1338.
