How is lacunar infarction treated?

Written by Tang Bo
Neurology
Updated on March 23, 2025
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Lacunar stroke is a type of cerebral stroke characterized by lesions smaller than 1.5 cm in diameter. Often, these can be discovered incidentally on a CT or MRI scan in asymptomatic patients. In such cases, it's important to evaluate whether the patient has risk factors such as hypertension or diabetes, and consider the patient's age, smoking, and drinking habits. Further assessments with cranial MRI angiography or other vascular imaging are recommended to clarify the state of the blood vessels and guide treatment. Additionally, some patients may experience an acute onset with symptoms like slurred speech or limb weakness. Although these symptoms might be mild, it is crucial to seek prompt medical attention to assess the blood vessels and guide further treatment based on the physician's physical examination of the patient.

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Written by Zhang Hui
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Imaging manifestations of cerebral infarction

For patients with cerebral infarction, in addition to collecting medical history and clarifying symptoms and signs, imaging examinations are also very important for the diagnosis and differential diagnosis of cerebral infarction. They are indispensable tools in clinical examinations. Cerebral infarction primarily requires cranial CT and MRI scans. On cranial CT, cerebral infarction lesions mainly appear as low-density areas and are easily distinguishable from cerebral hemorrhage. The lesions may cause swelling and have a certain mass effect. In cranial MRI, the appearance of cerebral infarction is primarily seen in diffusion-weighted imaging as a distinctly high signal, making it very easy to identify the responsible lesions. In T2-weighted images, the high signal is also clearly visible and easier to differentiate.

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Written by Chen Ya
Geriatrics
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How long can one survive after a stroke?

The lifespan after a stroke depends on the location and area of the stroke, the treatment received, and subsequent complications. Some patients with severe acute strokes are at risk of life-threatening conditions, and not everyone survives this acute phase. Those who do survive and enter the recovery and post-effects phases can extend their lifespan by controlling risk factors for stroke, delaying or preventing recurrence. Early rehabilitation, such as acupuncture during the early recovery phase, does not affect the normal lifespan in mild cases. However, recurrent strokes can shorten the lifespan, especially if complications like aspiration pneumonia occur afterward.

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Written by Tang Bo
Neurology
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Can lacunar infarction be treated?

Lacunar stroke is a type of cerebral infarction. It occurs due to long-term hypertension or other causes leading to arteriosclerosis in the small vessels inside the skull or other thrombus formations, leading to stroke. It is treatable, and the treatment is generally the same as for other types of strokes. Early on, depending on the patient’s condition, thrombolytic treatment can be chosen if it is within 4.5 hours from onset. However, if the symptoms are mild, the benefits and risks should be weighed. Treatment may also include antiplatelet therapy to improve circulation, lipid-lowering, and plaque stabilization. It is also necessary to tailor treatment to the individual patient and to further investigate whether there is significant narrowing of the vessels to guide prognosis.

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Written by Liu Yan Hao
Neurology
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Does cerebral infarction require long-term medication?

Patients with cerebral infarction need to take medication long term. Generally, patients with cerebral infarction have underlying diseases such as cerebral arteriosclerosis and hyperlipidemia, or hypertension, hyperlipidemia, and hyperglycemia. Therefore, cerebral infarction patients need long-term medication to control blood pressure, blood lipids, and blood sugar. Additionally, they should take antiplatelet drugs to prevent new thrombus formation and drugs to combat arteriosclerosis to prevent the worsening of cerebral arteriosclerosis and cerebral vascular stenosis. The focus of treatment is also on preventing other blood vessels from blocking, which could lead to a recurrence or worsening of cerebral infarction. Thus, patients with cerebral infarction need long-term medication and regular check-ups during the medication period, including blood tests and liver and kidney function tests, to monitor for any drug-induced liver or kidney damage. If no damage is apparent, they generally need to continue taking medication long-term. (Please take medication under the guidance of a professional physician.)

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Can someone who has had a cerebral infarction drink alcohol?

It is advised that individuals who have suffered a stroke should not consume alcohol. This is because strokes typically have specific causes, the most common of which include high blood pressure, diabetes, and high cholesterol. Strokes can also occur during times of emotional distress, and are often a result of unhealthy lifestyle habits and dietary patterns. Therefore, quitting smoking and alcohol is considered very important. Additionally, since many stroke patients also have high blood pressure, drinking alcohol can lead to excitement, which may cause an increase in blood pressure and potentially lead to another stroke.