Lacunar stroke

Adrià Arboix, Josep Lluís Martí-Vilaita

Research output: Contribution to journalReview articleResearchpeer-review

107 Citations (Scopus)

Abstract

Lacunar infarcts or small subcortical infarcts result from occlusion of a single penetrating artery and account for one quarter of cerebral infarctions. Patients with a lacunar infarct usually present with a classical lacunar syndrome (pure motor hemiparesis, pure sensory syndrome, sensorimotor stroke, ataxic hemiparesis or dysarthria-clumsy hand) and, less frequently, an atypical lacunar syndrome. Hypertension and diabetes mellitus are major risk factors for lacunar stroke. Lacunar infarcts show a paradoxical clinical course with a favorable prognosis in the short term, characterized by a low early mortality and reduced functional disability on hospital discharge, but with an increased risk of death, stroke recurrence and dementia in the mid- and long term. Asymptomatic progression of small-vessel disease is a typical feature of the lacunar infarcts. For this reason, lacunar infarction should be regarded as a potentially severe condition rather than a relatively benign disorder and, therefore, lacunar stroke patients require adequate and rigorous management and follow-up. Antiplatelet drugs, careful blood pressure control, the use of statins and modification of lifestyle risk factors are key elements in secondary prevention after lacunar stroke. © 2009 Expert Reviews Ltd.
Original languageEnglish
Pages (from-to)179-196
JournalExpert Review of Neurotherapeutics
Volume9
Issue number2
DOIs
Publication statusPublished - 1 Feb 2009

Keywords

  • Cognitive impairment
  • Lacunar infarct
  • Lacunar stroke
  • Prognosis
  • Risk factor

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