Is lacunar infarction a serious illness?

Written by Tang Bo
Neurology
Updated on September 07, 2024
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Lacunar stroke is a condition where small blood vessels in the cerebral hemispheres or brainstem undergo pathological changes and eventually become occluded as a result of common risk factors such as prolonged hypertension or diabetes. This leads to the necrosis of brain tissue. Typically, the infarct size is less than 1.5 to 2 centimeters, resulting in clinical syndromes associated with impaired neurological functions governed by the affected area. Often, lacunar strokes may be asymptomatic in some patients, while others may experience mild symptoms. Generally, the prognosis of this disease is good.

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Written by Tang Bo
Neurology
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Is lacunar infarction dangerous?

Lacunar stroke is caused by pathological changes in some small blood vessels inside our skull, due to long-term hypertension or other factors, such as diabetes or immune factors, leading to the occlusion of the vessel lumen and the formation of small infarct lesions. Therefore, when these lesions appear, there may be symptoms, or there may be no symptoms; however, regardless of the situation, the prognosis is generally good. It is also necessary to assess the blood vessels to see if there are any major vascular abnormalities. If major vascular abnormalities are present, it could still be dangerous. If the abnormalities are confined to small vessels, the prognosis is generally good.

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Written by Chen Ya
Geriatrics
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Brain infarction refers to the condition.

A cerebral infarction, commonly abbreviated, is typically referred to in full as thrombotic cerebral infarction or cerebral thrombosis. The most common cause is the formation of a local thrombus or from distant sites, such as the heart or major blood vessels, causing ischemia, hypoxia, and other disturbances in the cerebral blood supply. This results in localized ischemic necrosis or softening of brain tissue, leading to corresponding neurological deficits and signs.

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Written by Chen Ya
Geriatrics
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How long can someone with a complete paralysis from a cerebral infarction survive?

The life expectancy of patients with total paralysis from cerebral infarction cannot be generalized, as it depends on the size and location of the stroke, as well as the treatment received. A larger affected area, especially if the stroke occurs in a critical area like the brainstem, and if treatment is delayed, may result in the patient not surviving the acute phase due to high intracranial pressure, which can be fatal. If a patient survives the acute phase and moves into the residual effects phase, the outcome will depend on the rehabilitation treatment received, as well as care from family and community nursing. Such patients are prone to complications, such as pneumonia, which can be life-threatening. The initial stroke may not be fatal, but the treatment outcomes vary significantly. Some patients, if well cared for and treated promptly without recurring episodes, can have a comparatively long lifespan.

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Written by Chen Ya
Geriatrics
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How long does one need to be hospitalized for a cerebral infarction?

The duration of hospitalization for cerebral infarction varies from person to person, depending on the different conditions of the stroke patients, the different causes of the stroke, and the different treatment goals. Generally, the hospitalization time is seven to fourteen days. If the condition of the cerebral infarction is relatively mild, it is also possible to be discharged in five to seven days. However, for some patients with severe conditions, even those who are in a coma or have complications, the hospitalization time will be longer.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What should be done if the area of cerebral infarction is large?

If a large cerebral infarction occurs, brain edema often peaks within two to three days, and the mortality rate is extremely high. If medical attention is sought within six hours of onset, thrombolytic therapy can be considered. If emergency thrombolysis is exceeded, then only conservative drug treatment is available. For example, mannitol dehydration to reduce intracranial pressure, nourish neurons, protect brain cells, provide nutritional support, etc. After a stroke, it is essential to monitor changes in the patient's consciousness and pupils, dynamically assess the patient’s Glasgow Coma Score, and be aware of various potential complications. Family members should be well-informed about the patient's condition, etc. (Specific medications should be administered under the guidance of a doctor.)