Lacunar stroke – Causes and Symptoms of Lacunar Stroke

Lacunar strokes can be defined as strokes in which a small branch of a larger blood vessel causes the stroke. Because of the way blood vessels divide in the brain, lacunar strokes tend to occur in areas located away from the surface of the brain, where many of the smaller branches of large blood vessels are located.

As most brain areas perform a limited set of brain functions, the collection of symptoms of a given lacunar stroke usually falls within one of five categories of symptoms known to be caused by damage in these areas.

Lacunar strokes can be defined as strokes of any cause, in which the blood vessel that causes the stroke is a small branch of a larger blood vessel. Lacunar strokes are typically located in "deep areas" of the brain (i.e., away from the surface of the brain), where many of the smaller branches of large blood vessels are located. Lacunar infarcts are small (0.2 to 15 mm3) noncortical infarcts caused by occlusion of a single penetrating branch of a large cerebral artery. These branches arise at acute angles from the large arteries of the circle of Willis, stem of the middle cerebral artery (MCA), or the basilar artery.

Causes of Lacunar Stroke
Diabetes mellitus is well recognized as a risk factor for development of small vessel disease throughout the body, including the penetrating arteries.

Lacunes are caused by occlusion of a single deep penetrating artery. The deep penetrating arteries are small nonbranching end arteries (usually smaller than 500 micrometers in diameter), which arise directly from much larger arteries (eg, the middle cerebral artery, anterior choroidal artery, anterior cerebral artery, posterior cerebral artery, posterior communicating artery, cerebellar arteries, basilar artery).

The accumulation of blood from a cerebral hemorrhage can also press on parts of the brain and cause damage. A subarachnoid hemorrhage is caused by the rupture of a blood vessel that is usually located between the outside of the brain and the inside of the skull. The blood vessel at the point of rupture is often previously abnormal, such as from an aneurysm (an abnormal ballooning out of the wall of the vessel).

Initially, lipohyalinosis was thought to be the predominant small vessel pathology of lacunes; however, microatheroma now is thought to be the most common mechanism of arterial occlusion (or stenosis). Occasionally, atheroma in the parent artery blocks the orifice of the penetrating artery (luminal atheroma), or atheroma involves the origin of the penetrating artery (junctional atheroma).

Symptoms of Lacunar Stroke

The symptoms of lacunar stroke vary depending on the part of the brain that is deprived of its blood supply. Different areas of the brain are responsible for different functions, such as sensation, movement, sight, speech, balance and coordination.

Symptoms and lacunar lesion(s), demonstrated by MRI, that were responsible for the symptoms. One-hundred and fifty control subjects with MRI-proven lacunar lesions without neurological symptoms served as controls. There was no significant difference in age, sex and prevalence of known risk factors between cases and controls.

It is possible that due to narrowed blood vessels the ongoing blood supply
to parts of your brain is inadaquete and this needs to be assessed.

A TIA can cause many of the same symptoms as a stroke, but TIA symptoms are transient and last for a few minutes or up to 24 hours. Call for medical help immediately if you suspect a person is having a TIA, as it may be a warning sign that a stroke is about to occur. Not all strokes, however, are preceded by TIAs.