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Neurology (Expert Forum)
Lacunar Strokes and Alzheimers
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Lacunar Strokes and Alzheimers
by CCaldwell, Feb 11, 2001 12:00AM
Hello! In October my mother passed awy suddenly. She had had a complecated year of diagnostic dilemma. My mother had a pacemaker since the age of 51 for sick-sinus syndrome. In 1999 She had AV Node Abalation for constant botus of Atrial Fib and heart failure. When she had the Av Ab done she was very ill and when she came out of it she had a constant numbness in her left hand that never passed. They said not to worry about it. Then she began to become forgetful and mix things up, she almost burned the house down, flooded the bathroom etc etc etc, forgot how to cook the list goes on.
I complained to the doctor he said Alzheimers possibly. In July of 2000 she was hospitalized because she could not talk to me,remember or anyting this cleared with no major DX. On October 18 200- after a week of feeling exceptionally well, she woke up saying she felt funny, thhis went on for about 15 minutes I was calling the doctor when she went unresponsive and began seizing. Her heart rate was so fast I could not count it. Paramedics came and she was taken unresponsive. By 12 she was awake and speaking, They suspected Stroke and placed her in ICU, Her speech was garbled but no other neuro deficit. She slept at 6:30 she awoke became agitated, they gave her lasix and haloperidol. She then said I feel funny seized went into V-fib, then she was revived, she looked up knew who she was, where she was and said I feel weird and did it again and was never revived.
Her death certificate says stroke by the attending, her regular doctors summary say's cardiovascular event. Her records indicate small lacunar strokes back in July that they did not mention. My question is What is a lacunar stroke? Is is a severe stroke? Can it cause death? Does it present different? Does it show without contrast medium on a MRI? or CT? Can the stroke cause V-Fib after 12 hours? since all other neurological signs had been back to normal? We are just trying to determine what may have happened
and what a lacunar stroke is. She was diabetic and her BP was 240/122...Take care and Thank You
I complained to the doctor he said Alzheimers possibly. In July of 2000 she was hospitalized because she could not talk to me,remember or anyting this cleared with no major DX. On October 18 200- after a week of feeling exceptionally well, she woke up saying she felt funny, thhis went on for about 15 minutes I was calling the doctor when she went unresponsive and began seizing. Her heart rate was so fast I could not count it. Paramedics came and she was taken unresponsive. By 12 she was awake and speaking, They suspected Stroke and placed her in ICU, Her speech was garbled but no other neuro deficit. She slept at 6:30 she awoke became agitated, they gave her lasix and haloperidol. She then said I feel funny seized went into V-fib, then she was revived, she looked up knew who she was, where she was and said I feel weird and did it again and was never revived.
Her death certificate says stroke by the attending, her regular doctors summary say's cardiovascular event. Her records indicate small lacunar strokes back in July that they did not mention. My question is What is a lacunar stroke? Is is a severe stroke? Can it cause death? Does it present different? Does it show without contrast medium on a MRI? or CT? Can the stroke cause V-Fib after 12 hours? since all other neurological signs had been back to normal? We are just trying to determine what may have happened
and what a lacunar stroke is. She was diabetic and her BP was 240/122...Take care and Thank You
Doctor's Answer
by CCF Neuro[P] MD, RPS, Feb 11, 2001 12:00AM
Dear Kathy:
Sorry to hear about your mother. Lacunar infarcts are blockage of very small arteries. Usually the symptoms in these type of infarcts are sensory, motor, dysarthria, ataxia, or a combination of these symptoms. We usually think of these strokes arising from athrosclerosis due to things like diabetes. One can also see small vessel strokes in hypertension. When there are many of these in a person, there can be a corresponding dementia. To further complicate your mother's history is her atrial fibrillation. In this condition, it is well known that strokes can occur, especially more of the larger vessel strokes. Many times, lacunar strokes do not induce loss of consciousness, but they can. We see that a patient in ventricular fibrillation is in a very critical state, and many times these patients die, even when they are noticed immediately. The lack of blood flow that occurs with v-fib could make the level of consciousness variable when it starts for a short time if the fibrillation is transitory.
I hope that I have answered some of your questions.
Sincerely,
CCF Neuro MD
Sorry to hear about your mother. Lacunar infarcts are blockage of very small arteries. Usually the symptoms in these type of infarcts are sensory, motor, dysarthria, ataxia, or a combination of these symptoms. We usually think of these strokes arising from athrosclerosis due to things like diabetes. One can also see small vessel strokes in hypertension. When there are many of these in a person, there can be a corresponding dementia. To further complicate your mother's history is her atrial fibrillation. In this condition, it is well known that strokes can occur, especially more of the larger vessel strokes. Many times, lacunar strokes do not induce loss of consciousness, but they can. We see that a patient in ventricular fibrillation is in a very critical state, and many times these patients die, even when they are noticed immediately. The lack of blood flow that occurs with v-fib could make the level of consciousness variable when it starts for a short time if the fibrillation is transitory.
I hope that I have answered some of your questions.
Sincerely,
CCF Neuro MD
