What Medications Are Effective for Treating Lacunar Infarcts?
Lacunar infarction, commonly known as lacunar cerebral infarction, is a relatively special type of cerebral infarction that is frequently seen in clinical practice. Medication for lacunar infarction should be determined based on the condition and symptoms of the patient. Typically, drugs such as dehydrating agents, low-molecular-weight dextran, and heparin may be prescribed. It is important to follow the doctor's instructions and not to self-medicate blindly.
1. Acute phase treatment aims to improve blood circulation in the ischemic area of the brain and promote the recovery of neurological function as soon as possible. This includes:
(1) Relief of cerebral edema: For patients with severe and extensive infarction areas, dehydrating agents or diuretics may be used.
(2) Improvement of microcirculation: Low-molecular-weight dextran can be used to reduce blood viscosity and improve microcirculation.
(3) Blood dilution: This includes isovolemic hemodilution therapy, which involves venesection and replacement with an equal volume of fluid, as well as hypervolemic hemodilution therapy, which involves intravenous injection of non-blood-containing fluids to expand blood volume.
(4) Thrombolysis: Agents such as streptokinase and urokinase may be used.
(5) Anticoagulation: This is used to prevent thrombus extension and the formation of new thrombi. Drugs such as heparin and dicoumarol may be prescribed.
(6) Vasodilation: Vasodilators are generally considered to have uncertain effects and may sometimes worsen the condition in patients with increased intracranial pressure. Therefore, their use is not generally advocated in the early stages.
2. Rehabilitation phase treatment: Due to the plasticity of the central nervous system, there is a possibility of functional reconstruction during the recovery process after brain injury. Patients with motor disabilities caused by lacunar infarction can significantly reduce or alleviate the sequelae of paralysis through formal rehabilitation training. However, it is important to note that rehabilitation is not a simple process and should not be equated with mere "exercise". Hastiness can often lead to poor results and even cause joint and muscle injuries, fractures, pain in the shoulders and hips, exacerbation of spasms, abnormal spasm patterns and gait, as well as foot drop and varus deformities, which are collectively known as "misuse syndrome".
3. Sequelae treatment: After acute cerebrovascular disease, damage to the relevant central nervous system can lead to a series of symptoms such as hemiplegia, aphasia, and even coma. Although some patients' symptoms may gradually improve with treatment, approximately two-thirds of patients may still have residual symptoms such as numbness, abnormal sensation, joint contracture deformities, muscle atrophy, and cognitive decline. Rehabilitation treatment, including training for limb motor function, speech, swallowing, and bowel and bladder functions, is necessary. The earlier the treatment is started, the better the functional recovery.
Treating lacunar infarction is a concern for both patients and their families. The optimal time for treatment is within the first 3-6 months after onset. Dietary adjustments, such as maintaining a light and healthy diet with plenty of fresh vegetables and fruits, avoiding spicy and stimulating foods, and quitting smoking and alcohol, are also important. Appropriate exercise without overexertion and maintaining a pleasant mood are also crucial.
