Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What specific condition of small vessels can lead to lacunar strokes?

1. Vasculitis

2. Lipohyalinosis

3. Atherosclerosis

4. Thrombosis

The correct answer is: Lipohyalinosis

Lacunar strokes are a type of ischaemic stroke that occurs due to the occlusion of small penetrating arteries that supply deep structures of the brain, such as the thalamus and basal ganglia. Lipohyalinosis is a specific pathological condition that affects the small penetrating arteries, leading to changes in the vessel walls and ultimately resulting in the narrowing or occlusion of these vessels. This condition is characterized by the accumulation of lipids and the degeneration of the smooth muscle cells in the arterial wall, which significantly increases the risk of lacunar strokes. Lipohyalinosis is particularly associated with chronic hypertension and diabetes, which contribute to the development of microvascular disease. In these conditions, the small vessels are more susceptible to damage and can more easily become occluded, leading to the development of lacunar infarcts. Understanding the mechanics of lipohyalinosis is crucial for recognizing its role in stroke pathology, especially in younger patients or those with risk factors such as hypertension or diabetes.