Q: What is a lacunar stroke? How can you prevent having this type of stroke?
A: Lacunar strokes, like all strokes, are damaged areas in the brain. Like most strokes, they are caused when the flow of blood to an area of the brain is interrupted. Lacunar strokes are special because they involve small arteries near the center of the brain. These small arteries feed deep brain structures, such as your basal ganglia, thalamus or pons.
The arteries involved in a lacunar stroke branch sideways from large brain blood vessels just like this -- like a small branch on a large tree trunk. Because of their direct connection to large arteries, these vulnerable vessels are not shielded from peaks of high blood pressure.
High blood pressure is the main cause of lacunar strokes. It can cause direct damage to small arteries. Or it can dislodge debris (small clumps or clots) into the circulation, which can block flow downstream in these small vessels.
"Lacuna" is a Latin word meaning "pool" or "cavity." Lacunar strokes were named because autopsies revealed soft or liquefied areas in the brain where this type of stroke had occurred.
Lacunar strokes can cause dramatic symptoms. But they have a better recovery rate than other strokes.
The best way to prevent a lacunar stroke is to keep your blood pressure in the normal range. Your doctor may also suggest daily low-dose aspirin. If you have atrial fibrillation or certain other heart problems, you likely need an anti-coagulant drug, such as warfarin (Coumadin).
(Mary Pickett, M.D., is an Associate Professor of Medicine at Oregon Health and Science University, where she is a primary care doctor for adults. Dr. Pickett is a Lecturer for Harvard Medical School and a Senior Medical Editor for Harvard Health Publications.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)
Lacunar stroke effects small, branch arteries in the brain
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