Strokes consist of an interruption in the flow of blood sent to the brain due to various causes. When this flow stops, the brain stops feeding on oxygen and nutrients, leading to damage or death of brain cells in a particular area of the brain.

But there are different types of strokes. Usually these strokes damage the brain tissue in the outermost or surface area of the brain. However, when these damages occur in the innermost structures of the brain we speak of lacunar infarction . We will talk about this type of alteration in the following lines.

What is a lacunar infarction?

Lacunar infarction refers to a type of stroke in which one of the arteries that supply blood to structures inside the brain becomes blocked , leaving the brain without the supply of oxygen and nutrients it needs 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 carries the blood with a lot of pressure.

When a person suffers a lacunar infarction, the cells in a relatively limited area of the brain begin to be damaged or die due to lack of oxygen. As 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 infarctions account for 20% of the strokes people have.

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 a lacunar infarction will depend on the area of the brain that is being damaged. These symptoms include

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

If a person suffering from high blood pressure does not receive any kind of treatment, it is very likely that he or she will suffer a series of lacunar infarctions that lead to the appearance of additional symptoms such as dementia or emotional behavior.

Also, if you notice one or more of the above symptoms you should be alert, as this could also mean that you are about to have a more serious heart attack.

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:

1. Pure motor syndrome

In this type of lacunar accident, the person experiences paralysis or decreased muscle strength that affects an entire side of the body equally. This paralysis is called hemiparesis and affects about 50% of people who have suffered a lacunar infarction.

2. Ataxic hemiparesis

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

3. Hand clumsiness and dysarthria

In this case the person suffers a decrease in dexterity and precision of hand movements. In addition, 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 . You may also experience alterations in sensation that cause you discomfort such as pain or burning sensation in the affected part of the body.

5. Sensory-motor syndrome

A person suffering from 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 impairment, all on the same side of the body.

Causes and risk factors

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

Hypertension problems

It’s the most common cause. The fragility of the arteries of lacunar infarctions carries 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 infarctions.

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 infarction at some point are

  • Sedentary life
  • Unhealthy eating
  • High cholesterol levels
  • Smoking
  • Consumption of alcoholic beverages
  • Drug use
  • Sleep Apnea
  • Pregnancy

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, minimises 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 severe 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 need a general rehabilitation which includes the following aspects:

  • Physical therapy sessions to restore motor skills
  • Neuropsychological rehabilitation to promote cognitive functions
  • Occupational therapy to facilitate the patient’s day-to-day life
  • Speech therapy intervention in case of language damage
  • 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 major strokes, lacunar infarction is associated with a higher recovery rate, showing improvements in the hours or days following the infarction.