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[Lacunar stroke].

M Yu Maksimova1, T S Gulevskaya1

  • 1Research Center of Neurology, Moscow, Russia.

Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova
|December 12, 2019
PubMed
Summary
This summary is machine-generated.

Lacunar stroke, often caused by hypertension and atherosclerosis, is linked to small deep brain infarcts. Advanced MRI reveals these infarcts, impacting cognitive decline and predicting future strokes.

Keywords:
cerebral microangiopathylacunar strokesmall deep (lacunar) infarction of the brain

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Area of Science:

  • Neurology
  • Neuroradiology
  • Pathology

Background:

  • Lacunar stroke is a significant subtype of ischemic stroke, comprising ~25% of cases.
  • Pathogenesis is frequently linked to cerebral microangiopathy from arterial hypertension (AH) and atherosclerosis (AS).
  • Small deep infarcts (SDI) are the underlying structural basis of lacunar stroke.

Purpose of the Study:

  • To review the morphology, pathogenesis, and clinical/neuroimaging dynamics of lacunar stroke.
  • To explore diagnostic criteria for differentiating hypertensive and atherosclerotic SDI.
  • To highlight the impact of asymptomatic SDI on cognitive function and stroke risk.

Main Methods:

  • Literature review focusing on historical aspects and recent advancements.
  • Analysis of neuroimaging findings, particularly MRI, for SDI detection.
  • Synthesis of data on pathogenesis, clinical presentation, and prognostic factors.

Main Results:

  • Widespread use of advanced MRI has improved the identification of SDI at all stages.
  • Hypertensive and atherosclerotic SDI exhibit distinct characteristics and progression.
  • Asymptomatic SDI contribute to cognitive impairment, vascular dementia, and predict future strokes.

Conclusions:

  • Understanding lacunar stroke pathogenesis and SDI is crucial for patient management.
  • Neuroimaging plays a vital role in diagnosing and characterizing SDI.
  • Asymptomatic SDI represent a significant risk factor for cognitive decline and recurrent cerebrovascular events.