Lacunar infarction: causes, symptoms and treatment

Stroke (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 the damage or death of brain cells in a specific area of ​​the brain.

But there are different types of cerebrovascular accident, usually these attacks damage the brain tissue of the outermost or superficial area of ​​the brain. But nevertheless, When these damages occur 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.

• You may be interested: "Cerebral embolism: types, symptoms, sequelae and causes"

What is a lacunar infarction?

Lacunar infarction refers to a type of stroke in which one of the arteries supplying blood to structures inside 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, these come directly from a main artery which carries blood with much Pressure.

When a person suffers a lacunar infarction, cells in a relatively limited area of ​​the brain begin to be damaged or die due to lack of oxygen. Taking into account that a large number of internal brain structures cooperate in communication and coordination of body movements, a lacunar infarction can pose a significant risk of disability.

Compared to other types of strokes, lacunar infarcts account for 20% of the strokes suffered by people.

• You may be interested: "Parts of the human brain (and functions)"

Lacunar infarct symptoms

Since different brain areas control various functions such as movement, sight, speech, etc., the Symptoms that warn 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:

• Weakness or paralysis on face, arm, leg or foot
• Weakening or paralysis of the eye muscles
• Sudden muscle numbness
• Movement problems
• Speech problems

If a person who suffers from high blood pressure does not receive any type of treatment, it is very likely that he will suffer a series of lacunar infarcts that lead to the appearance of additional symptoms such as dementia or conduct emotional.

Likewise, if the person perceives one or more of the above symptoms, they must be alert, since This could also mean that you are about to have one more stroke. serious.

Types of lacunar syndromes

As mentioned above, both symptoms and consequences can vary depending on the area of ​​the brain affected by the lacunar infarction.

There are five main lacunar syndromes, out of a list of approximately 85. They are as follows.

1. Pure motor syndrome

In this type of lacunar accident, the person experiences a paralysis or decrease in muscular vigor that affects the entire side of the body in the same way. This paralysis is called hemiparesis and affects approximately 50% of people who have suffered a lacunar infarct.

2. Ataxic hemiparesis

This consequence is characterized by partial paralysis, or paresis, of variable severity and great difficulty in coordinating movements, or ataxia, of the extremities, the legs being more affected than the arms.

3. Clumsiness in the hands and dysarthria

In this case, the person suffers a decrease in dexterity and precision of hand movements. What's more, this deficit is accompanied by difficulties in 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 transient numbness on one side of the body. Likewise, you may suffer alterations in sensitivity that cause discomfort such as pain or 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 a mixture of symptoms of hemiparesis and hemiplegia. These symptoms include a decrease in strength on one side of the body, along with paralysis and sensory disturbance, all on the same side of the body.

• Related article: "Hemiparesis: types, symptoms, causes and treatment"

Causes and risk factors

There are a series of diseases and conditions associated with the appearance of lacunar infarcts. Some of the most significant causes are:

Hypertension problems

It is the most common cause. The fragility of the arteries from lacunar infarcts 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 lacunar infarction.

In addition, other risk factors that predispose people to suffer a lacunar heart attack at some point are:

• Sedentary life
• Unhealthy eating
• Elevated cholesterol levels
• Smoking
• Consumption of alcoholic beverages
• Consumption of drugs
• Sleep apnea
• Pregnancy

Treatment and prognosis

An emergency intervention in a person who has just suffered a lacunar infarct It increases the chances of surviving the accident and, furthermore, 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 heart attack 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 a 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 day-to-day
• Speech therapy intervention in the event of language damage
• Psychological therapy to work on the emotional aspects of the consequences of the heart attack. *** Drug therapy ** to eliminate the underlying causes of the lacunar accident

Unlike other larger cerebrovascular accidents, lacunar infarction is associated with a higher recovery rate, presenting improvements in the hours or days following the infarction.

Bibliographic references:

• 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.
• Grau-Olivares, M.; Arboix, A.; Bartrés-Faz, D.; Junqué, C. (2007). Neuropsychological abnormalities associated with lacunar infarction. Journal of the Neurological Sciences. 257 (1–2): pp. 160 - 165.
• 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.