Monday, March 16, 2009

Lacunar Stroke or Lacunar Infarction

My mom started off the year with some troubling health issues. She's usually quite healthy, except for high blood pressure that has plagued her for years, sometimes rising high enough to cause a hypertensive crisis that required hospital treatment. It was a hard winter and Mom was occasionally experience "funny feelings" that I call the "feeling of impending doom." The day that those uneasy feelings wouldn't resolve, Mom went to the ER at St. Mary's hospital in Galesburg, IL. Another hypertensive emergency was discovered, and the excellent staff at St. Mary's initiated further diagnostic testing. A CT of the brain came back showing "something" that needed further investigation by MRI. All of that uncertainty and unfolding drama did not help Mom's blood pressure issues resolve at that point--and in fact, probably spiked the blood pressure of Dad, me, my brother and sister! (I'm quite certain that it did.)

The MRI revealed evidence of "several" old areas of Lacunar strokes. These are also known as Lacunar infarcts (infarctions). Mom had no classic symptoms of stroke that she can recall, so it's difficult to know when those tiny clots formed. Lacunar strokes can also be described as "subcortical strokes." High blood pressure is definitely a risk factor, along with diabetes, and atherosclerosis.

Lacunar strokes are a type of ischemic stroke. They occur deep in the brain in the smallest of the brain's blood vessels. When thinking of the circulatory system as a tree with roots and branches, the large vessels taper to smaller ones that branch out all over the body. Lacunar infarcts occur in blood vessels that would be like the tiny twigs on the branch of a tree.

A few years ago there was a push to change the term "stroke" to "brain attack." The new term never really caught on in places that I've lived and worked. But I have seen an increase in the number of hospitals that have become certified stroke centers.. The American Stroke Association cautions that "time lost is brain lost." Recognizing the signs of stroke and seeking care immediately are essential to ensure the best possible outcome.

Fortunately, Mom is doing much better and has no lingering effects from her recent health emergency. Her medications were tweaked to give her better control over her blood pressure and her daily aspirin dosage was increased. She’s recently started attending the Sunday auctions again, and that’s kind of how we gauge wellness in our family.

For good information about Lacunar strokes, these reputable sites are recommended:

  • Johns Hopkins

  • Harvard Medical School

  • National Stroke Association

  • National Institute of Neurological Disorders and Stroke (NINDS)

    • Know symptoms of a Stroke and act Face Arms SpeechTime

      Face--weakness on one side of the face can be noted by a smile that "droops" on one side.
      Arms--the inability to hold both arms straight out to the side (level with the shoulders) without one of them drifting downward is a sign of concern.
      Speech--slurred speech or the inability to accurately repeat a sentence are symptoms of concern
      Time--Make a note of the time when symptoms begin & provide that information to your healthcare professionals at the hospital. Strokes caused by clots can be treated with a strong clot-busting drug--but only if the symptoms started less than 3 hours before.

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