Lacunar Stroke

Stroke caused by lacunar infarction or other small vessel diseases of the brain. It features hemiparesis (see PARESIS), hemisensory, or hemisensory motor loss.

Also Known As:

Stroke, Lacunar; Infarct, Lacunar; Lacunar Syndrome; Infarctions, Lacunar; Infarcts, Lacunar; Lacunar Infarct; Lacunar Infarction; Lacunar Infarctions; Lacunar Infarcts; Lacunar Strokes; Lacunar Syndromes; Strokes, Lacunar; Syndrome, Lacunar; Syndromes, Lacunar; Infarction, Lacunar

Networked: 683 relevant articles (28 outcomes, 151 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Stroke (Strokes)
2.	Ischemic Stroke
3.	Hemorrhage
4.	Lacunar Stroke
5.	Hypertension (High Blood Pressure)

Experts

1.	Benavente, Oscar R: 24 articles (08/2019 - 01/2011)
2.	McClure, Leslie A: 21 articles (01/2021 - 01/2011)
3.	Hart, Robert G: 15 articles (08/2017 - 04/2011)
4.	Markus, Hugh S: 14 articles (01/2022 - 02/2003)
5.	White, Carole L: 10 articles (08/2019 - 01/2011)
6.	Pearce, Lesly A: 10 articles (08/2017 - 08/2012)
7.	Iso, Hiroyasu: 9 articles (08/2020 - 08/2002)
8.	Staals, Julie: 9 articles (12/2017 - 05/2008)
9.	SPS3 Investigators: 9 articles (06/2015 - 01/2011)
10.	van Oostenbrugge, Robert J: 9 articles (03/2013 - 05/2008)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Lacunar Stroke:

1.	Cilostazol (Pletal)FDA LinkGeneric 01/01/2014 - "The ECLIPse study was a multicenter, randomized, double-blind, placebo-controlled trial that evaluated the difference between the efficacy of cilostazol and a placebo to reduce the PI in patients with acute lacunar infarction using serial TCD examinations. " 01/01/2016 - "The Effect of Cilostazol in Acute Lacunar Infarction Based on Pulsatility Index of Transcranial Doppler (ECLIPse) study showed a significant decrease in transcranial Doppler pulsatility index (PI) with cilostazol treatment after 90 days of acute lacunar infarction. " 01/01/2014 - "The aim of the present study was to perform a subgroup analysis of the ECLIPse study in order to explore the effect of cilostazol in acute lacunar infarction based on cerebral white matter hyperintensities (WMH) volume. " 01/01/2014 - "The Effect of Cilostazol in Acute Lacunar Infarction Based on Pulsatility Index of the Transcranial Doppler (ECLIPse) study showed a significant decrease in the transcranial Doppler (TCD) pulsatility index (PI) with cilostazol treatment at 90 days after acute lacunar infarction. " 01/01/2014 - "Cilostazol decreases cerebral arterial pulsatility in patients with mild white matter hyperintensities: subgroup analysis from the Effect of Cilostazol in Acute Lacunar Infarction Based on Pulsatility Index of Transcranial Doppler (ECLIPse) study."
2.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 07/01/2013 - "Biochemical aspirin resistance in one's series was rather rare (2.4%) and was more prevalent in patients with lacunar strokes. " 10/01/2006 - "Cessation of microemboli in the middle cerebral artery after a single dose of aspirin in a young patient with emboliogenic lacunar syndrome of carotid origin." 05/01/2002 - "Females were found to be less frequently on prior aspirin (P = .02) and had fewer lacunar strokes (P = .005). " 01/01/1995 - "Of the aspirin-treated lacunar infarct patients, 58 received 325 mg or lower-dose aspirin, and 15 received 600-1,300 mg of aspirin. " 12/20/2012 - "We report on a 60-year-old hypertensive woman who developed right-sided thalamic haemorrhage 5 days after sustaining a lacunar infarct of the left thalamus for which she had been prescribed a dual antiplatelet therapy: aspirin and clopidrogrel. "
3.	Clopidogrel (Plavix)FDA Link 02/04/2014 - "In patients with a recent lacunar stroke while taking ASA, the addition of clopidogrel did not result in reduction of vascular events vs continuing ASA only. " 02/04/2014 - "This study provides Class I evidence that for patients with recent lacunar stroke while taking ASA, adding clopidogrel as compared to continuing ASA alone does not reduce the risk of recurrent stroke." 12/01/2014 - "In the SPS3 trial, patients with recent (within 6 months) symptomatic lacunar infarcts from 81 centres in North America, Latin America, and Spain were randomly assigned, in a two-by-two factorial design, to target levels of systolic blood pressure (1:1; 130-149 mm Hg vs <130 mm Hg; open-label) and to a once-daily antiplatelet treatment (1:1; aspirin 325 mg plus clopidogrel 75 mg vs aspirin 325 mg plus placebo; double-blind). " 08/01/2011 - "The results of trials of clopidogrel plus aspirin in patients with lacunar strokes and acute TIAs are forthcoming. " 08/01/2017 - "Patients with recent magnetic resonance imaging (MRI)-documented lacunar infarcts were randomly assigned in a factorial design to target levels of systolic blood pressure (130-149mmHg vs <130mmHg; open label) and to antiplatelet treatment (aspirin/clopidogrel vs aspirin/placebo; double-blinded). "
4.	Platelet Aggregation Inhibitors (Antiplatelet Drugs)IBA 04/17/2003 - "When 81 patients from both the BD and MLS groups were analyzed, logistic regression analysis showed that number of lacunar infarct, severity of white matter hyperintensity, and use of antiplatelet agents were significantly associated with MBs. " 01/01/1999 - "Other domains should still be explored: are antiplatelet agents also effective to reduce the risk of cerebral ischaemia in patients with other causes, especially lipohyalinosis of the deep perforators leading to lacunar infarcts? " 08/01/2019 - "Escalation of antithrombotic treatments beyond standard single antiplatelet agents has not been effective in long-term lacunar stroke prevention efforts, unequivocally increasing intracerebral hemorrhage risk without providing a significant benefit. " 04/01/2015 - "We aimed to evaluate the efficacy of antiplatelet agents in secondary stroke prevention after a lacunar stroke. " 04/01/2015 - "Our results suggest that any of the single antiplatelet agents compared with placebo in the included trials is adequate for secondary stroke prevention after lacunar stroke. "
5.	Cytidine Triphosphate (CTP)IBA 06/01/2015 - "CTP offers an improved diagnostic benefit over NCCT and CTA for the diagnosis of lacunar infarction." 01/01/2022 - "Patients with lacunar stroke who had magnetic resonance imaging and CTP performed were enrolled in the study. " 12/01/2016 - "Recent studies demonstrated superiority of CTP to NCCT/CTA at detecting lacunar infarcts. " 08/01/2015 - "Perfusion deficits and mismatch are frequent in lacunar infarcts, but larger studies are warranted to elucidate the clinical significance of these CTP findings." 04/27/2023 - "CTP does not allow to reasonable exclude lacunar infarct if no perfusion deficit is found, but the pathophysiology of lacunar infarct is more complex than previously thought."
6.	ozagrelIBA 12/01/1996 - "Sodium ozagrel is considered to be effective in the acute phase of lacunar infarction." 12/01/2016 - "The present study suggested that ozagrel was safe to use but did not improve functional outcomes in patients with atherothrombotic or lacunar infarction." 11/01/2004 - "The sodium ozagrel is recommended in the treatment of acute lacunar infarction. " 12/01/2016 - "We investigated whether ozagrel was beneficial for patients with atherothrombotic stroke or lacunar infarction. " 12/01/2016 - "Ordinal logistic regression analyses showed that ozagrel use was not significantly associated with modified Rankin Scale score at discharge in patients with atherothrombotic stroke (odds ratio: .99; 95% confidence interval: .88-1.11) or in those with lacunar infarction (odds ratio: 1.00; 95% confidence interval: .87-1.16). "
7.	EdaravoneIBA 01/01/2009 - "This study investigated the effect of edaravone on the outcome of patients with acute lacunar infarction. " 07/01/2005 - "Administration of edaravone improves the outcome of patients with lacunar infarction." 07/01/2005 - "The effect of edaravone as an inhibitor of ischemic brain damage in addition to routine treatment was retrospectively examined in 70 patients with lacunar infarction who were admitted within 24 hours of symptom onset. " 01/01/2009 - "Edaravone improves the outcomes of patients with acute lacunar infarction, especially motor palsy, without regard to the conventional therapy performed concomitantly." 07/01/2005 - "Efficacy of edaravone, a free radical scavenger, for the treatment of acute lacunar infarction."
8.	Free Radical ScavengersIBA 12/11/2009 - "These obsetvations suggest that lacunar stroke patients should be treated with edaravon, which is a free radical scavenger usually prescribed for cases of major strokes, as it will likely improve the prognosis of these patients." 07/01/2005 - "Efficacy of edaravone, a free radical scavenger, for the treatment of acute lacunar infarction." 01/01/2009 - "Efficacy of the free radical scavenger, edaravone, for motor palsy of acute lacunar infarction." 03/30/2011 - "Free radical scavenger, edaravone, reduces the lesion size of lacunar infarction in human brain ischemic stroke."
9.	Ligases (Synthetase)IBA 09/01/2019 - "The improved multiple ligase detection reaction (iMLDR) method was used to analyze the genotypes of seven single-nucleotide polymorphisms (SNPs) in the COL4A2 gene (rs3803230, rs391859, rs4103, rs445348, rs76425569, rs7990383, rs9515185) in a case-control study of 406 lacunar stroke patients and 425 controls. " 09/05/2017 - "MATERIAL AND METHODS The improved multiple ligase detection reaction (iMLDR) method was used to analyze the genotypes of 6 tag SNPs in the CCL11 gene (rs1129844, rs17809012, rs1860183, rs1860184, rs4795898, and rs4795895) in a case-control study of 406 lacunar stroke patients, 214 large-artery atherosclerotic (LAA) stroke patients, and 425 controls. "
10.	Tissue Plasminogen Activator (Alteplase)FDA Link 01/01/2018 - "This study tested the hypothesis that non-lacunar stroke patients with no visible vessel occlusion on baseline imaging would have a favorable outcome regardless of treatment with alteplase. " 01/01/2014 - "The aim of the present study was to assess whether the time interval based on time of Alteplase IV infusion may influence the effect of treatment in patients with non-lacunar stroke. " 01/01/2008 - "The aim of this study was to examine the rate of early neurological deterioration (END) and favorable outcomes after acute lacunar stroke following the use of intravenous recombinant tissue plasminogen activator (IV rtPA). " 01/01/2019 - "In patients with lacunar strokes, a favorable outcome was observed in 31 of 53 patients (59%) in the alteplase group compared with 24 of 52 patients (46%) in the placebo group (adjusted odds ratio [aOR], 1.67 [95% CI, 0.77-3.64]). " 01/01/2019 - "Of patients with lacunar infarcts, 55 (50.9%) were assigned to treatment with alteplase and 53 (49.1%) to receive placebo. "

Therapies and Procedures

1.	Therapeutics 01/01/2021 - "Intensive versus guideline-recommended blood pressure reduction in acute lacunar stroke with intravenous thrombolysis therapy: The ENCHANTED trial." 01/01/1993 - "Thus capsular lacunar syndromes with prior ipsilateral TIA or RIND are not as benign as previously thought, and they should indicate more intensive studies including cerebral angiography, and more vigorous therapy." 01/01/2023 - "Antiplatelet Therapy or Not for Asymptomatic/Incidental Lacunar Infarction." 01/01/2022 - "Despite anticoagulation, PFO closure, and antiplatelet therapy, the patient had recurrent lacunar infarcts in the pons and deep white matter, as well as subcortical microhemorrhages. " 01/01/2020 - "Risk factors associated with progressive lacunar strokes and benefit from dual antiplatelet therapy."
2.	Secondary Prevention 08/01/2019 - "Studies are warranted to investigate if vigorous-intensity activity is effective as secondary prevention in patients with a lacunar stroke." 06/01/2019 - "The effects of physical exercise in patients with lacunar stroke, seem promising in secondary prevention and only few studies have investigated the effect of high-intensity interval training in patients with lacunar stroke. " 06/01/2015 - "There is no evidence at this time supporting body size-based modifications to current BP targets for secondary prevention after lacunar stroke. " 04/01/2015 - "Efficacy of antiplatelet therapy in secondary prevention following lacunar stroke: pooled analysis of randomized trials." 01/01/2023 - "To comprehensively compare the efficacy of different antiplatelet therapies for secondary prevention of lacunar stroke (LS). "
3.	Length of Stay 06/01/1996 - "Lacunar infarctions (LI) are associated with an excellent functional prognosis and mortality is exceptional during hospital stay. " 08/01/2001 - "Patients with pure motor stroke showed a better outcome than patients with non-lacunar stroke with a significantly lower number of complications and in hospital mortality rate, shorter duration of hospital stay, and a higher number of symptom free patients at hospital discharge. " 10/01/2001 - "Cost savings were estimated as a decrease in the length of stay for most stroke patients, whereas the most benign (lacunar) strokes were assumed to be managed in a non-acute setting. " 04/01/1999 - "Subjects sustaining a partial anterior circulation infarct, lacunar infarct, or posterior circulation infarct achieved the mobility milestones most rapidly and generally had a shorter hospital stay. " 02/01/2002 - "In patients with lacunar strokes, stroke unit care was associated with a longer length of hospital stay (18 versus 13.5 days for stroke unit care versus stroke team care, respectively; P<0.01) and significantly greater use of therapy. "
4.	Activities of Daily Living (ADL) 05/01/2000 - "We believe that for dementia with multiple lacunar infarctions, diffusely affected cerebrum including white matter lesions, which results in low ADL scores for symptoms, may be a prerequisite." 04/01/1992 - "Our results suggest that deep white matter lesions observed as PVL on CT and ventricular enlargement were the most important factors contributing to intellectual impairment in patients with multiple lacunar infarcts, and that physical factors such as ADL and age can be considered to be related to the development of dementia." 03/10/2015 - "SPS3 (Secondary Prevention of Small Subcortical Strokes) was a clinical trial in lacunar stroke patients with annual assessment of disability using the Older Americans Resources and Survey instrumental activities of daily living (IADL) scale (range 0-14). " 12/01/2005 - "In the logistic regression analysis, low ADL function, medium or large infarction, and intracerebral hemorrhage (vs lacunar infarction) were significantly associated with discharge to a destination other than home. " 12/01/2018 - "As independent variables we used age, gender, onset-to-admission interval, side of hemiparesis, trunk control, Motricity Index (MI), presence of obesity, presence of neglect, presence of depression, classification of cerebral infarction (total anterior circulation, partial anterior circulation, posterior circulation or lacunar infarcts), degree of independence in activities of daily living, and cognitive state, all assessed at admission. "
5.	Transplantation 01/01/2013 - "Bone marrow stromal cell transplantation enhances recovery of motor function after lacunar stroke in rats." 01/01/2012 - "We hypothesized that transplantation of neural stem cells (NSCs) with the capacity of differentiating into diverse cell types such as neurons and glia, but with limited proliferation potential, would constitute an alternative and/or adjuvant therapy for lacunar stroke. " 01/01/2017 - "Transplantation at the delayed subacute phase showed muse cells differentiated into neural cells, facilitated neural reconstruction, improved functions, and displayed solid safety outcomes over prolonged graft maturation period, indicating their therapeutic potential for lacunar stroke." 06/01/2015 - "Within 6 weeks, large numbers of SPIO-labeled BMSCs reached the lacunar infarction area from the transplantation region through the corpus callosum. " 06/01/2015 - "Short-, middle- and long-term safety of superparamagnetic iron oxide-labeled allogeneic bone marrow stromal cell transplantation in rat model of lacunar infarction."