LACUNAR SYNDROMES

Course overview

LACUNAR SYNDROMES ARE CLINICAL MANIFESTATIONS OF LACUNAR INFARCTIONS, WHICH ARE DEFINED AS SMALL SUBCORTICAL LESIONS LESS THAN 15 MILLIMETERS IN DIAMETER THAT ARE CAUSED BY OCCLUSION OF A PENETRATING ARTERY FROM A LARGE CEREBRAL ARTERY, MOST COMMONLY FROM THE CIRCLE OF WILLIS. THESE PENETRATING ARTERIES ARISE AT SHARP ANGLES FROM MAJOR VESSELS AND ARE THUS ANATOMICALLY PRONE TO CONSTRICTION AND OCCLUSION. OTHER COMMON SOURCES OF THESE PENETRATING ARTERIES INCLUDE THE MIDDLE CEREBRAL ARTERY AND THE BASILAR ARTERY. THERE ARE OVER 20 LACUNAR SYNDROMES THAT HAVE BEEN DESCRIBED, BUT THE MOST COMMON ARE PURE MOTOR HEMIPARESIS, PURE SENSORY STROKE, ATAXIC HEMIPARESIS, SENSORIMOTOR STROKE, AND DYSARTHRIA-CLUMSY HAND SYNDROME. THIS ACTIVITY DESCRIBES THE RISK FACTORS, EVALUATION, AND MANAGEMENT OF LACUNAR SYNDROMES AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN ENHANCING CARE DELIVERY FOR AFFECTED PATIENTS.