How is lacunar stroke treated?

Written by Sheng Wang
Neurology
Updated on September 30, 2024
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Lacunar infarction is a cerebrovascular disease. For lacunar infarctions caused by arteriosclerotic atherosclerosis, the main treatment is to prevent recurrence of infarction and dislodged plaques that cause blockages. Therefore, it is necessary to initiate treatments like aspirin, antiplatelet therapy, and atorvastatin to lower blood lipids and stabilize plaques. It is also important to control risk factors such as high blood pressure, diabetes, smoking, as well as conditions like hyperuricemia and hyperhomocysteinemia.

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Geriatrics
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What should be noted for cerebral infarction?

People with old myocardial infarctions need to pay attention to their diet. A low-salt, low-fat diet is recommended. Additionally, individuals like Student Shi who have difficulty swallowing must be careful not to choke, as this can lead to aspiration pneumonia. If they really cannot eat, they may need to have a gastric tube inserted for feeding. Emotionally, it is crucial to control emotional fluctuations as they can cause blood pressure spikes, potentially leading to further progression of a cerebral infarction. Regarding medications, they must be taken on time and regularly to prevent risk factors including hyperlipidemia and hypertension. Blood pressure should also be controlled within the normal range. Furthermore, functional exercise is essential, particularly for those suffering from sequelae post-infarction, to prevent local muscle atrophy and stiffness.

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Written by Liu Yan Hao
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Symptoms of cerebral infarction

Patients with cerebral infarction may exhibit paralysis of one side of the body and aphasia. If the patient has a brainstem infarction, symptoms may include unclear speech, difficulty swallowing, and coughing while eating. In cases of cerebellar infarction, there may not be symptoms of hemiplegia; the main symptom is usually dizziness. Additionally, large-scale cerebral infarctions can lead to disturbances in consciousness, manifesting as coma. Typically, cerebral infarctions do not affect consciousness unless they are extensive, which may also lead to coma. Moreover, patients with cerebral infarction often experience symptoms while resting quietly, commonly waking up in the morning to find themselves unable to speak or with paralysis on one side of the body, although their consciousness remains clear. These are typical manifestations of cerebral infarction.

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Geriatrics
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How should a stroke and a cold be handled?

It is recommended to actively address a cold in cases of cerebral infarction, as most people with cerebral infarction who also have motor disabilities are predominantly bedridden, making them prone to aspiration pneumonia. If a cold is not managed well and develops into pneumonia, it can further aggravate the condition, potentially worsening the perceived motor disabilities if timely functional rehabilitation is not administered, leading to further progression of the illness.

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Neurology
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Lacunar Infarct Nursing Issues

Lacunar stroke is caused by the blockage of small blood vessels in our skull due to long-term risk factors such as hypertension, diabetes, or hyperlipidemia, leading to a stroke. Generally, the area of infarction is relatively small, typically less than 1.5 to 2 centimeters. Symptoms may or may not be present. In either case, the symptoms are usually mild and the prognosis is generally good. There are no special strict nursing requirements. If patients are active and can take care of themselves, they do not need special care. Furthermore, it is crucial to focus on secondary prevention, which is to prevent further occurrence of stroke, and to seek further treatment from a neurologist.

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Cerebral infarction X-ray manifestations

Brain infarction generally does not involve X-rays because X-rays primarily target bone issues, not brain tissue issues. If a brain infarction occurs, a cranial CT or MRI can be performed. In acute cases of sudden onset, a cranial CT is primarily used to exclude cerebral hemorrhage, as brain infarction typically does not show up in the acute phase. However, in cases of extensive brain infarction, changes might also appear on a CT during the acute phase. Additionally, after the acute phase, about 1 day or 24 hours later, brain infarctions generally appear as low-density shadows on a CT. On an MRI, in diffusion imaging, brain infarctions generally appear as high-density, high-signal areas, while they appear as low-signal areas in T1 imaging and high-signal areas in T2 imaging. It is also suggested to perform cranial magnetic resonance angiography to examine the status of the blood vessels.