A health condition that happens when a blood clot blocks a tiny blood vessel deep in the brain is called a lacunar stroke. In general, this is a medical emergency that requires immediate treatment. Otherwise, it may lead to permanent brain damage and even death.
In other words, a lacunar stroke is a type of ischemic stroke that occurs when a blood clot reduces or blocks blood flow to certain small blood vessels deep in the brain. Sometimes, this condition is called a lacunar infarct.
What Are The Symptoms of Lacunar Stroke?
The symptoms of lacunar stroke are very similar to those of other types of ischemic strokes. Check some examples below:
- Dysarthria (slurred or garbled speaking)
- Aphasia (difficulty speaking or even a complete loss of speech)
- Weakness or paralysis that usually affects only one side of the face and body
- Loss of muscle control (on one side of the face)
- Diplopia (double or blurred vision)
- Dizziness
- Vertigo
- Nausea
- Vomiting
- Ataxia (loss of coordination or clumsiness)
- Sudden loss of any of your senses, including vision, hearing, smell, taste, and touch
If any of the previous symptoms occur, immediately contact your healthcare provider. People who do not get diagnosed in the early stages may experience serious and even life-threatening complications.
What Are The Warning Signs of a Lacunar Stroke?
Usually, lacunar strokes cause multiple symptoms, and to recognize warning signs of a stroke, remember the acronym BE FAST. It means:
- Balance (You should watch for sudden loss of balance)
- Eyes (Sudden loss of vision or changes in one or both eyes)
- Face (Smile and look for a drop on one side of the face)
- Arms (Commonly, people with a stroke cannot raise one or both arms)
- Speech (You may notice slurred speech or difficulty finding words)
- Time (Immediately call 911 or go to the nearest emergency room if any of the previous signs appear)
Causes
This type of ischemic stroke occurs when a blood clot restricts or blocks blood flow in one of the blood vessels deep in the brain. These deep layers of the brain are responsible for senses and movement (including the thalamus and basal ganglia). There are multiple causes of lacunar strokes. Examples include:
- Hypertension (high blood pressure)
- Hyperlipidemia (high cholesterol)
- Clotting disorders
- COVID-19
- Infections that destroy tissue in the body (It may happen in people with sepsis when dead pieces can break free and enter the bloodstream)
Risk Factors
One of the most significant risk factors is high blood pressure. Talk with your healthcare professional about ways to manage hypertension and maintain it at a safe level. Check below for other factors that could increase your risk of developing lacunar stroke:
- Age – Older adults (over the age of 65) are more prone to lacunar stroke compared to younger adults.
- Race – According to some studies, Black people are more prone to lacunar stroke.
- Smoking (including all forms of tobacco or nicotine)
- Prolonged use of recreational or over-the-counter (OTC) drugs
- A genetic mutation in the NOTCH3 gene can make you more likely to develop a lacunar stroke
- Atrial fibrillation (AFib)
- Alcohol use disorder
- Atherosclerosis (plaque buildup in the arteries)
- Diabetes
What Happens if a Lacunar Stroke is Left Untreated?
Those who suffer from a lacunar stroke and do not get treatment may also experience some complications. Check some of them below:
- Motor deficits
- Speaking problems
- Loss of balance and coordination
- Neurological function problems
- Sensory loss
- Cognitive impairment
- Vascular dementia
- Mood disorders (such as post-stroke depression)
- Recurrence
- Functional disability
- Physical complications (including deep vein thrombosis, pulmonary embolism, urinary tract infections, pressure ulcers, and others)
- Binswanger’s disease (a health condition that causes severe damage to the white matter)
The previous list does not contain a complete list of complications. However, you can consult with your doctor about ways to reduce the risk or even prevent them.
How to Prevent Lacunar Stroke?
Unfortunately, it is not always possible to prevent this condition, but doctors may recommend some tips that can reduce the risk. These include:
- Stop smoking – If you have problems with smoking cessation, discuss it with your physician.
- Limit or avoid alcoholic drinks
- Manage chronic health conditions (including high cholesterol, diabetes, high blood pressure, and others)
- Physical exercise – You should aim for 30 minutes of physical exercise per day, at least 5 days a week, to get or maintain a healthy weight.
- Dietary changes – Doctors usually recommend limiting processed foods and eating more fresh fruits, vegetables, and whole grains.
Your doctor may also recommend regular checkups because multiple health conditions that can cause lacunar strokes develop over time and often do not cause symptoms in the early stages.
Diagnosis
Commonly, the diagnosis of a lacunar stroke starts with a physical and neurological examination to check for abnormalities linked to the disease. Physicians may also ask some questions about your medical history and symptoms to get more clues about your disorder. However, to confirm or rule out a lacunar stroke, they often perform the following tests. These include:
- Blood tests
- CT (computerized tomography) scans
- Electrocardiogram (EKG)
- MRI (magnetic resonance imaging scans)
- Electrocardiogram (EKG or ECG)
Treatment
One of the most important parts of the lacunar stroke treatment is to restore blood flow to the brain. That’s why physicians often recommend the following treatments. They also help reduce the risk of permanent damage to the brain. For example:
- Thrombolytic therapy – This option involves specific medicines that dissolve blood clots. Usually, people should administer them once they begin to experience stroke symptoms.
- Mechanical thrombectomy – This is a type of surgery used to remove the blood clot. During this procedure, surgeons will use a small and flexible tube (catheter) that is inserted into a major blood vessel. Therefore, they will thread the catheter up to the blood clot in the brain. However, this surgery is not an option for everyone because, in most cases, the blood clots in people with lacunar strokes are too small.
- Blood thinners (also known as anticoagulants) – This group of medicines is used to prevent or treat blood clots.
- Antihypertensives – These medications are used to treat hypertension (high blood pressure).
In addition, if the condition is diagnosed in more advanced stages, people often also need the following therapies that help regain abilities they have had before. Check some examples below:
- Speech therapy – It is used to improve language and speaking abilities. It also may help to control the muscles that are involved in speaking, eating, breathing, and swallowing.
- Physical therapy – This therapy is used to strengthen the muscles, which help improve balance and regain the ability to use arms and legs.
- Occupational therapy – Doctors often recommend this therapy to help you safely complete daily activities, especially those that require precise body movements.
Frequently Asked Questions
What foods and drinks should be avoided by people with a lacunar stroke?
Healthcare professionals often recommend adding and removing some foods and drinks to reduce the risk of complications and worsening the symptoms. Check some foods and drinks below that you should avoid if you are diagnosed with lacunar stroke:
- Alcoholic and caffeinated drinks
- Foods that contain large amounts of sugar and salt (Sodium)
- Fried foods
- Highly processed foods (including deli meat)
When should I go to the ER?
You should go to the nearest emergency room (ER) or call 911 if you or a loved one experiences symptoms of any of the following health conditions. These include:
- DVT (deep vein thrombosis)
- Pulmonary embolism
- Heart attack (also known as myocardial infarction)
- Seizures
- Pneumonia
What are transient ischemic attacks?
This is a health condition that causes certain temporary effects very similar to a stroke. Sometimes, it is called a “mini-stroke”, and it is a warning sign that indicates an increased risk of a true stroke.
Can you recover fully from a lacunar stroke?
Many people can recover partially or even fully from a lacunar stroke, especially if it is treated quickly. Because these strokes affect small areas of the brain, outcomes are often better compared to more severe types of stroke. However, recovery depends on several factors, including the location of the stroke, how soon treatment begins, and overall health. Rehabilitation therapies (physical, occupational, and speech therapy) play a key role in maximizing recovery.
Are lacunar strokes less serious than other types of stroke?
Lacunar strokes are sometimes considered “smaller” strokes, but that does not mean they are harmless. They can still cause severe disability, especially if they occur repeatedly. Multiple lacunar strokes over time can lead to cognitive decline, problems with walking, and vascular dementia. Every stroke should be treated as a medical emergency.
Can lacunar strokes happen more than once?
Yes, lacunar strokes can recur, particularly if underlying risk factors such as high blood pressure, diabetes, or high cholesterol are not managed. Furthermore, recurrent strokes increase the risk of long-term complications, including physical disability and cognitive impairment. This is why prevention and regular medical follow-up are essential after an initial stroke.
