Lacunar infarction of the brain: signs, treatment, prevention
Lacunar cerebral infarction refers to pathological ischemic changes that occur in the depth of the brain tissue as a result of impaired blood flow in the perforating vessels. These small foci are transformed into lacuna, hence the name of the disease.
According to statistics, in persons older than 80 years, predominantly male with a diagnosis such as a stroke, these lacunae are found in 30% of cases.
Is it dangerous or not?
Not so long ago, the formation of small foci of ischemia was not considered a dangerous condition that could affect the health and life of the patient. But the data of the last decade show that lacunar infarction often leads to the development of age-related dementia. In 30% of cases, cognitive deficits may occur, and 40% of patients with this diagnosis suffer from vascular parkinsonism. Therefore, it becomes obvious that the consequences of lacunar cerebral infarction can significantly affect the quality of life, especially in the case of a recurrent course.
After ascertaining this type of cerebral ischemia, the life expectancy of the patient is from 5 to 7 years. Therefore, experts came to the conclusion that in fact, a lacunar infarct refers to an insidious and dangerous pathology.
Risk factors for
Risk factors for the development of such a disease are:
- Violations of the integrity of small vessels in certain diseases( diabetes, hypertension, CRF).
- Cardiopathology( cardiosclerosis, arrhythmia).
- Chronic insufficiency of cerebral circulation.
- Acute disorders of hemodynamics( arrhythmic, hypertonic and other crisis).
- Diseases of cerebral vessels( due to hereditary predisposition, autoimmune disorders, infection).
Manifestations of lacunar infarction
This disease can occur without a pronounced clinical picture, sometimes manifests itself as a micro stroke, or transient ischemic attack. Features of this condition are:
- presence in the past or present of arterial hypertension;
- absence of meningeal signs;
- the patient does not lose consciousness;
- no motor or sensory aphasia;
- slow development of focal symptoms;
- favorable prognosis with complete recovery of functions or minor neurologic impairment;
- no signs of pathology in the passage of angiography patients, on MRI or CT scan - detection of small-scale changes with reduced density.
In a study conducted by scientists from the University of Kyoto, it was found that the inability to maintain body balance for more than 20 seconds, standing on one leg with the eyes open, is one of the signs of small lesions in small vessels of the brain. This circumstance can serve as an additional sign of the disease, even in the absence of other symptoms.
Treatment and therapy
For the purpose of proper treatment, the physician should identify the cause of the development of this pathology. Most often, the patient is diagnosed with hypertension. To monitor the level of pressure should use a constant intake of antihypertensive drugs. However, it is not recommended to reduce pressure quickly, using strong drugs. It is especially dangerous to do this in the elderly, as well as in the presence of stenosis of the carotid and vertebral arteries.
When diabetes is necessary to strengthen control, and make maximum efforts to achieve optimal levels of glucose in the blood.
With high cholesterol and other signs of atherosclerosis, life-long ingestion of statins is recommended. In addition, regardless of the cause, lacunar infarction should be eliminated with drugs that are used for ischemic stroke.
In order to prevent the development of dementia, a course of drugs that improve the nutrition of the brain( neuroprotectors and nootropics) is recommended. It is recommended to take aspirin from 50 mg, or other types of anticoagulants, to prevent the development of thrombi and blood thinning.
It is very important for a lacunar stroke to undergo a full rehabilitation program of rehabilitation, and use all measures to prevent its recurrence.
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