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Tuesday, May 21, 2013
Can a lacunar infarct cause cerebral atrophy?
I am a 53 year old woman with a history of major depression and anxiety. I just had an MRI and the findings said that I have had a lacunar infarction and there is evidence of "mild supratentorial cerebral atrophy". Was that caused by the infarction? Does this put me at risk for Alzheimer`s/some other form of dementia? Will the atrophy get worse over time? Thank you...
The mild supratentorial atrophy is a nonspecific finding and because it is mild it is probably a subjective finding by the radiologist. There are multiple causes for the atrophy. Your physician must evaluate you for the causes. Again, since it is mild it is possibly a subjective finding. The incidental finding of lacune also warrant further investigation. Your physician must evaluate you for all the risk factors (hypertension, diabetes, high cholesterol for stroke, over weight, tobacco smoking, alcohol consumption etc...). He should also initiate work up for the cause of the lacunar stroke though it was asymptomatic. You should self start by modifying the risk factors that include weight loss, exercise, low fat diet, abstain from tobacco, hydration etc..) The lacunar infarction and the mild atrophy are possibly not related. If the atrophy is real, then the cause will determine prognosis for further atrophy. The bottom line evaluation must be initiated for both the atrophy and lacunar stroke. This might be a red flag and prompt steps might alter the course. Best regards and hope the above helps.
Yousef Mohammad, MD, MSc
Director, Stroke Fellowship Program
College of Medicine
The Ohio State University