Related Subjects:
|Neurological History taking
|Causes of Stroke
|Ischaemic Stroke
About
- Lenticulostriate branch occlusion: Occlusion of the small penetrating arteries branching from the middle cerebral artery (MCA).
- Anatomy: Involves the proximal area M1 and distal segment M2 of the MCA.
- Division: The MCA splits into superior and inferior divisions.
Aetiology
- Most often caused by small vessel strokes or due to occlusion of the M1 segment.
- Characterized by absence of cortical signs such as dysphasia or neglect.
Perfusion
- MCA Branching: The M1 segment branches in the Sylvian fissure to form the M2 segments.
- Lenticulostriate arteries: These branches supply the putamen, outer globus pallidus, posterior limb of the internal capsule, corona radiata, and caudate nucleus.
Clinical Presentation due to Occlusion of lenticulostriate arteries
- Pure motor stroke: Hemiparesis affecting face, arm, and leg on one side.
- Pure sensory stroke: Hemisensory loss on one side.
- Clumsy hand-dysarthria syndrome: Facial weakness, slurred speech, and clumsiness of one hand.
- Vascular Parkinsonism: Parkinsonian features due to subcortical ischaemia.
- Hemiballismus: Involuntary, flinging movements of one side of the body.
Additional Information
Lacunar strokes result from occlusion of small penetrating arteries and account for about 20% of all ischemic strokes. They are commonly associated with hypertension and diabetes mellitus.
Management
- Medical therapy: Control of risk factors such as hypertension, diabetes, and hyperlipidemia.
- Antiplatelet agents: Aspirin or other antiplatelet medications to prevent further strokes.
- Rehabilitation: Physical, occupational, and speech therapy as needed.
References
- Adams HP Jr, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. Stroke. 1993 Jan;24(1):35-41.
- Caplan LR. Lacunar infarction and small vessel disease: pathology and pathophysiology. J Stroke. 2015 May;17(2):2-6.