Lacunar Strokes. Lacunar infarcts are a series of very tiny, ischemic strokes, which cause clumsiness, weakness, and emotional variability. They are actually a subtype of thrombotic stroke and constitute about 38% of this major group. In some populations, such as among Japanese, they are the most common stroke subtypes. They can also sometimes serve as warning signs for a major stroke.
Silent Brain Infarctions. Many elderly people have silent brain infarctions, small strokes that cause no apparent symptoms. They are detected in between 10 - 38% of elderly patients who undergo imaging tests for problems other than stroke. A 2002 study suggested that they double the risk for future stroke. They also may be major contributors to mental impairment in the elderly. Smokers and people with hypertension are at particular risk.
Transient Ischemic Attacks (TIAs)
Transient ischemic attacks (TIAs) are mini-ischemic strokes, usually caused by tiny emboli (clots often formed of pieces of calcium and fatty plaque) that lodge in an artery to the brain. They typically break up quickly and dissolve but they do temporarily block the supply of blood to the brain. The mental or physical disturbances resulting from TIAs generally clear up in less than a day, with nearly all symptoms resolving in less than an hour.
However, experts now advise that a TIA should be taken very seriously and treated as aggressively as a stroke. Both stroke and TIA increase the risk for a subsequent stroke. Moreover, the risk for having another stroke can be as high as 40% within 5 years. The American Heart Association / American Stroke Association recommends these guidelines to prevent a second stroke after TIA:
Lifestyle changes.
- Stop smoking
- Limit alcohol
- Increase exercise (30 minutes a day of moderate physical activity)
- Lose excess weight (waist measurements should be no more than 35” for women and 40” for men; body mass index should be between 18.5 and 24.9)
Drug treatments.
- Drugs to control cholesterol, high blood pressure, and (for people with diabetes) high blood sugar levels
- Antiplatelet therapy such aspirin, dipyridamole, or clopidogrel)
Previous Section
