Related Experiment Video
Updated: Sep 23, 2026
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Long-term prognosis after lacunar infarction
1Department of Clinical Neuroscience, Division of Neurology, Lund University Hospital, Sweden. bo.norrving@neurol.lu.se <bo.norrving@neurol.lu.se>
Insights
Lacunar infarcts, a common cause of ischemic stroke, are not benign long-term. Patients face increased risks of death, recurrent stroke, cognitive decline, and dementia years after the initial event.
Area of Science:
- Neurology
- Vascular Medicine
- Stroke Research
Background:
- Lacunar infarcts are small, deep ischemic strokes caused by penetrating artery occlusion.
- Previously considered benign, recent evidence suggests long-term risks.
- They constitute approximately 25% of all ischemic strokes.
Purpose of the Study:
- To evaluate the long-term prognosis and associated risks following lacunar infarcts.
- To identify prognostic factors influencing outcomes in lacunar stroke patients.
- To highlight the need for further research into prevention and management strategies.
Main Methods:
- Review of recent studies on lacunar infarct outcomes.
- Analysis of risk factors and prognostic implications.
- Assessment of long-term risks including mortality, recurrence, and cognitive decline.
Main Results:
- Lacunar infarcts carry an increased risk of death, primarily from cardiovascular causes, years post-event.
- Recurrent stroke risk is comparable to other ischemic stroke types.
- Patients exhibit a higher likelihood of developing cognitive decline and dementia.
Conclusions:
- Lacunar infarcts have significant long-term implications beyond the acute phase.
- Age, vascular risk factors, nocturnal blood pressure, and small vessel disease severity are key prognostic indicators.
- Targeted risk-factor modification is crucial for managing lacunar stroke patients.
Abstract:
Lacunar infarcts, small deep infarcts that result from occlusion of a penetrating artery, account for about a quarter of all ischaemic strokes. These infarcts have commonly been regarded as benign vascular lesions with a favourable long-term prognosis. However, recent studies have shown that this is only the case early in the disease course. A few years after infarct, there is an increased risk of death, mainly from cardiovascular causes. The risk of recurrent stroke after lacunar infarct is similar to that for most other types of stroke, and patients have an increased risk of developing cognitive decline and dementia. Age, vascular risk factors, high nocturnal blood pressure, and severity of cerebral small-vessel disease at onset have significant prognostic implications for almost all outcomes. More studies on mechanisms, prevention, and treatment are needed to provide specific guidance on the long-term management of patients with lacunar infarcts. Risk-factor modification is likely to play a large part in therapeutic interventions targeted at this stroke subtype.
Related Concept Videos
01:15Ischemic Stroke ll: Pathophysiology
01:35Long-term Potentiation