Lacunar syndromes

Lacunes are small fluid-filled cavities, < 1.5 cm in diameter, which are found in the basal ganglia, the thalamus, the internal capsule, the pons and the cerebral and cerebellar white matter. They are the result of infarction secondary to the occlusion of the small penetrating branches of the major intracranial arteries. They are frequently multiple.

They are apparent in approximately 25% of strokes.

Possible clinical features include:

• the patient is likely to be conscious
• an infarct in the areas described may cause a pure sensory, pure motor or mixed motor and sensory deficit
• sudden onset unilateral cerebellar ataxia, and sudden dysarthria with a clumsy hand are typically caused by by single lacunar infarcts