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One study in Japan does state that the frequency of lacunar infarcts has decreased since the 1960s due to more aggressive control of risk factors, primarily hypertension. ĭata comparing the frequency of lacunar strokes among different sexes, races, and worldwide populations are not readily accessible. Īnother source reports that a quarter of all ischaemic strokes (a fifth of all strokes) are lacunar type. There are over 20 lacunar syndromes that have been described, but the most common ones are pure motor hemiparesis, pure sensory stroke, ataxic hemiparesis, sensorimotor stroke, and dysarthria-clumsy hand syndromeĪ US study found around 16% of first ischemic strokes in the United States are lacunar strokes and in the African-Americans communuties lacunar infarctions accounted for 22% of first-time ischemic stroke events.

These anatomical sites correspond to lesions at the lenticulostriate arteries, the anterior choroidal artery, thalamoperforant arteries, paramedian branches of the basilar artery, and the recurrent artery of Heubner from the anterior cerebral artery.

Subcortical white matter structures (internal capsule and corona radiate).

Basal ganglia (globus pallidus, putamen, thalamus, and caudate).

The anatomic distribution of lacunar syndromes and infarctions is most commonly in the Image shows rotating brain, hypothalamus=red, amygdala=green, hippocampus/fornix=blue, pons=gold, pituitary gland=pink Other common sources of these penetrating arteries include the middle cerebral artery and the basilar artery. These small arteries arise at sharp angles from major vessels and are anatomically prone to constriction and occlusion. Lacunar infarctions are defined as small subcortical lesions with a size of less than 15 mm in diameter caused by occlusion of a penetrating artery from a large cerebral artery, most commonly from the Circle of Willis. This 3 minute video introduces the topic well

In addition to cognitive decline and dementia, gait problems are also frequently associated with cSVD. cSVD has a crucial role in lacunar cerebral infarction and deep or cortical haemorrhages.

Lacuna stroke are caused by Cerebral small vessel disease (cSVD) a term used for different pathological processes that affect the small vessels of the brain.Lacunar stroke is not benign 30% of patients are left dependent, and scant long term data suggest that up to 25% of patients have a second stroke within 5 years.Although a recognised stroke subtype for over 50 years, the cause of lacunar ischaemic stroke, and whether it is different to cortical ischaemic stroke, remains under debate.Lacunar infarcts are small infarcts (2–20 mm in diameter) in the deep cerebral white matter, basal ganglia, or pons, presumed to result from the occlusion of a single small perforating artery supplying the subcortical areas of the brain.4 Mechanism of Injury / Pathological ProcessĪ quarter of all ischaemic strokes (a fifth of all strokes) are lacunar type.