Mild Lacunar Stroke Symptoms and Treatment Options

A mild lacunar stroke, also referred to as a minor cerebral infarction, typically presents with subtle symptoms. It may cause temporary numbness or weakness on one side of the body, such as in a single limb—either an arm or a leg. Additional signs can include brief episodes of slurred speech or clumsiness in hand movements. These symptoms are often short-lived but should still be taken seriously.

Approaches to Treating Mild Lacunar Stroke

The treatment for a mild lacunar stroke is largely consistent with that of other types of cerebral infarction. In the acute phase, if the NIHSS (National Institutes of Health Stroke Scale) score is below 7, thrombolytic therapy is generally not required. Similarly, if the NIHSS score falls between 4 and 7 and there is no significant language impairment, clot-busting drugs are not typically administered. Instead, secondary prevention strategies for ischemic cerebrovascular disease are implemented.

Medication and Secondary Prevention

This preventive strategy often involves dual antiplatelet therapy using medications like aspirin and clopidogrel. The duration of dual therapy depends on whether there is significant intracranial large vessel stenosis. If stenosis is present, dual antiplatelet treatment is continued for approximately three months, after which a single agent is maintained long-term. In cases without significant stenosis, dual therapy is limited to about three weeks before transitioning to a single medication for ongoing use.

In addition to antiplatelet therapy, patients are typically prescribed statins to manage cholesterol levels. The goal is to reduce low-density lipoprotein (LDL) cholesterol to below 1.8 mmol/L or by at least 50% from baseline levels.

Managing Comorbid Conditions

For patients with hypertension, blood pressure should be controlled to below 140/90 mmHg. Those who can tolerate more aggressive management, especially if diabetes is also present, should aim for a target of less than 130/80 mmHg. Glycemic control is equally important, along with lifestyle modifications such as quitting smoking and limiting alcohol consumption.

Recovery and Rehabilitation

Once the acute phase has passed and the patient enters the recovery stage, regular physical activity becomes a key component of rehabilitation. Engaging in moderate exercise for at least 30 minutes to an hour each day can significantly aid in regaining function and improving overall cardiovascular health.