SHARES
“I was fine and had no pain or anything. I had never heard of a lacunar stroke before. But then it was just this weird kind of sensation. I felt a little bit dizzy and my eyes were playing funny. After some time, my speech was getting slurred and I stumbled when I walk. Finally after scans & tests, my doctor told me I had a lacunar stroke.” Ben, 66, who has recovered from his stroke and is working towards a healthier lifestyle.
What is Lacunar Stroke?
Lacunar stroke occurs when a small part of your brain cells die because of disrupted blood supply of the small blood vessels deep in the brain. These dead brain cells break down and become liquid-liked, forming small pools of water that resembles little lakes (“lacunes”) on imaging.
In the USA, about 20% of all strokes are lacunar strokes.
Photo from newtimes.co.rw
How is Lacunar Stroke Different from Other Strokes?
Most of the time (a high 87%), stroke occurs due to blocked or disrupted blood supply in the brain (ischaemic strokes). There are two types of ischaemic strokes. Blood clots from the large neck and heart vessels travel to the brain and clog up the brain blood vessels, cause an embolic ischaemic stroke. The second type, the thrombotic ischaemic stroke occurs when diseased or damaged cerebral arteries become blocked by a blood clot formed within the brain, rather than from elsewhere. Ischaemic strokes usually happen in blood vessels that supply blood to the outer part or surface of the brain (which is responsible for consciousness).
In contrast, lacunar stroke is caused by diseased small blood vessels that fail to supply blood in the deep brain tissue. These blood vessels cause strokes because they are leaky, dilated, irregularly thickened or narrowed but rarely due to a thrombotic clot. The surrounding brain cells can die because of pressure from the dilated vessels. Less often, the small vessels can rupture, causing microbleeds that damages nearby brain tissue.
Since the surface of brain is not always affected in lacunar infarct, patients usually are awake and conscious with some normal vision, language ability and fully aware of their surrounding (spatially orientated).
How do I know if I have Lacunar Stroke?
Lacunar strokes affect each of us differently. You can have slurred speech with weakness or paralysis of the face, arm, leg, foot or toes, difficulty speaking or walking and affected vision. Also, you may experience loss of sense to light touch and feel pain in the affected body part.
Be it lacunar stroke or not, it is important for us to learn to identify stroke as early as possible and call ambulance immediately. “BE FAST” can help you identify a stroke quickly and immediately.
Balance – Unable to stand or walk straight
Eyes – Loss of vision, “swinging” eyes
Face – When smiling, one side of face droops.
Arms – When keeping both arms raised to shoulder level with eyes closed, one arm is weaker and falls lower.
Speech – Slurred speech, difficulty in getting words out, or getting the right word
Time – if any of the above is present, call the ambulance! The faster we get treated, the better is our chance in recovering fully.
Am I at Risk for Lacunar Stroke?
Ageing put us at higher risk for lacunar stroke. Although people aged 65 and above get affected more commonly, young people can have stroke too. In general, men are more prone to stroke than women. Having diabetes mellitus, high blood pressure and high cholesterol put us at higher risk too. Also, lacking exercise, obesity, smoking and consuming too much alcohol can increase our risk for stroke as well. By adopting a healthy lifestyle and keep an eye on our diet, we can prevent ourselves from getting a stroke attack.
Can I Recover from Lacunar Stroke?
Yes, about 80% of patient recovers fully after a lacunar stroke. Outcome and functioning is generally better for those with lacunar stroke as compared to those with ischaemic stroke. Make sure to stick tight to your rehabilitation programme. Your physiotherapist and occupational therapist are always there to help you. Do give yourself some time and patience to recover.
It is also important to note that lacunar stroke can recur. The best way to prevent it is to change your lifestyle and food choice to a better one and keep your blood pressure, blood sugar and cholesterol under control. Your doctor will provide you with a daily dose of blood thinner to aid in your effort of preventing stroke from recurring. Sometimes, your doctor may do more test like a heart monitor to find out other preventable cause to your stroke.
Photo by John Snow from Flickr
Conclusion
Lacunar stroke, just like any other stroke, can leave us permanently paralysed and disabled. It is a consequence of years and years of unhealthy lifestyle and food choices. Prevention of stroke starts today for young and old alike. Your doctor is there to help you!
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References:
1. Wardlaw JM. What causes lacunar stroke? Journal of Neurology, Neurosurgery and Psychiatry. 2005;76(5):617-19.
2. Yulu S, Joanne MW. Update on cerebral small vessel disease: a dynamic whole brain disease. Stroke and Vascular Neurology. 2016
by Chang Xian
View all articles by Chang Xian.
