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Lacunar Strokes

June 21, 2019

As we move up into the brain, the last type of thing that we often see is actual what we call lacunar strokes, which is essentially a stroke of the tiniest little arteries in the brain. And so what you end up having is you have these big pipes that come up and they split into smaller pipes and off the smaller pipes coming to those little feathery vessels that supply very important areas of the brain and the brainstem. And things like diabetes, high blood pressure, high cholesterol are very hard in those arteries and they can collapse. And essentially what they do is they scar up and then they’ll block off. And we called those lacunar strokes. And those account for our large percentage of the strokes that we see. It’s interesting, the same pathology can actually occur, and instead of that artery blocking off the scar tissue, makes the artery weak and then the artery ruptures. And so in the same places we see lacunar strokes, this is the same place as where we actually can see hemorrhages in some people. Why some people have hemorrhages and other and other people have lacunar strokes where there’s a clot? We don’t know exactly why, but that’s certainly what happens. And again, the key answer or the key sort of take home message in those cases is prevention, prevention, prevention, and it’s blood pressure, blood pressure, blood pressure, cholesterol, diabetes. And so those are the major causes of ischemic stroke that we see, in general, which is cardioembolic often from A Fib, carotid artery stenosis, and then actual strokes from the blood vessels in the brain called lacunar strokes.

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