Lacunar stroke

Disease class: Cerebral small vessel diseases
 Disease class: Stroke

Also known as

• Lacunar stroke 
• Lacunar infarct (LACI) 

This is a type of ischaemic stroke. It results from the occlusion of small penetrating arteries which provide blood to the brain's deep structures.

 

Etymology

C. Miller Fisher observed "lacunae" (empty spaces) in the deep brain structures after occlusion of 200–800 μm penetrating arteries and connected them with five classic syndromes.

 

Types

• Pure motor stroke / hemiparesis (occurs in 33–50%)
• Ataxic hemiparesis (second most frequent)
• Dysarthria / clumsy hand (sometimes considered a variant of ataxic hemiparesis)
• Pure sensory stroke
• Mixed sensorimotor stroke 
• Silent lacunar infarction. There are no symptoms despite a loss of brain tissue. This often considered to be a non-stroke syndrome because a diagnosis of stroke can be made clinically. However a diagnosis of silent lacunar infarction must be identified by radiological imaging or post-mortem examination.

 

Epidemiology

• It is estimated that lacunar infarcts account for 25% of all ischaemic strokes.
• There is an annual incidence of approximately 15 per 100,000 people. 
• They may be more frequent in men .
• They may be more frequent in people of African, Mexican, and Hong Kong Chinese descent.