Certified Neuroscience Registered Nurse (CNRN) Practice Exam

In the context of lacunar strokes, what is an important aspect of management?

1. Aggressive blood pressure control

2. Increased fluid intake

3. Immediate surgical intervention

4. Reduction of cholesterol levels

The correct answer is: Aggressive blood pressure control

Aggressive blood pressure control is a crucial aspect of managing lacunar strokes, primarily because these types of strokes are often associated with chronic hypertension and lipohyalinosis, which leads to small vessel disease. Controlling blood pressure is essential in reducing the risk of recurrent strokes and managing other cardiovascular risks. High blood pressure can exacerbate the underlying mechanisms that lead to lacunar strokes, such as further damage to the small penetrating arteries in the brain. Therefore, implementing a targeted approach to lower blood pressure can substantially improve outcomes and prevent future strokes. While increased fluid intake might be important in certain clinical scenarios, it is not specifically indicated for managing lacunar strokes. Immediate surgical intervention is typically not a common practice for lacunar strokes, as they generally do not present as candidates for surgical procedures. Reducing cholesterol levels, although a component of overall cardiovascular care, does not specifically address the immediate concerns associated with lacunar strokes and their management priorities. Thus, aggressive blood pressure control stands out as the most relevant management strategy in this context.