Lacunar infarcts and lacunar syndromes

Abstract

Lacunar infarcts, small deep infarcts that result from occlusion of a penetrating artery, account for about a quarter of all ischemic strokes. Patients with a lacunar infarct usually present with a classical lacunar syndrome (pure motor hemiparesis, pure sensory syndrome, sensorimotor stroke, ataxic hemiparesis or dysarthria - clumsy hand) and, less frequently, an atypical lacunar syndrome. These infarcts have commonly been regarded as benign vascular lesions with a favorable short-term prognosis comparing with other ischemic stroke subtypes. However, there is an increased risk of mortality mainly from cardiovascular causes, stroke recurrence which is similar to that for most other types of stroke, and patients have an increased risk of developing cognitive decline and dementia in long term. Although hypertension and diabetes mellitus are major risk factors for lacunar stroke, the other potential risk factors should be determined. Risk-factor modifications, antiplatelet and antihypertensive drugs with strict blood pressure are likely to play a major part of therapeutic interventions of lacunar stroke.