II. Definitions
- Lacune
- Small cavity (from latin, "small lake") remaining after a deep brain tissue infarct
III. Pathophysiology
- Small infarct size (<1.5 cm)
- Occlusions in small, deep, penetrating vessels result in microinfarctions in the distal MCA branches
- Small deep penetrating or perforating arteries (Lenticulostriate arteries) arising at head of Middle Cerebral Artery
- Lenticulostriate arteries (MCA)
- Thalmogeniculate arteries (PCA)
- Paramedian perforators (Basilar Artery)
- Regions affected
- Basal Ganglia
- Corona radiata
- Thalamus
- Brainstem (e.g. paramedian pons)
- Internal Capsule
IV. Causes
V. Findings: Signs and Symptoms
- Pure motor or sensory deficits (Lacunar Syndrome)
VI. Findings: Patterns following lacunar stroke
- Pure Motor Hemiparesis (33-50% of Lacunar Infarcts)
- Affects posterior limb of Internal Capsule or corona radiata
- Contralateral Hemiparesis of face, arm or leg
- No sensory deficit
- Dysarthria may also be present
- Ataxic Hemiparesis
- Affects Internal Capsule, pons or corona radiata
- Contralateral Hemiparesis of the face and leg
- Ataxia of the contralateral arm and leg
- Pure Sensory Stroke
- Affects Thalamus or corona radiata
- Contralateral hemisensory loss of face, arm, leg
- Sensory-Motor Stroke
- Affects Thalamus, Internal Capsule or Putamen-capsule-caudate
- Ipsilateral sensory and motor loss of the face, arm, leg
- Clumsy Hand Dysarthria
- Affects pons or Internal Capsule
- Dysarthria and Dysphagia
- Contralateral arm and hand clumsiness (dysmetria, weakness, dysdiadochokinesis)
- Contralateral facial paresis and Tongue weakness
VII. Imaging
VIII. Resources
- Lacunar Stroke Syndromes (Case Western School of Medicine)
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MSH) | Brain infarction that affects small subcortical vessels due to occlusion of a penetrating artery deep in the brain. It may lead to lacunar stroke. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D059409 |
| SnomedCT | 230698000, 81037000 |
| Japanese | ラクナ梗塞, ﾗｸﾅｺｳｿｸ |
| Spanish | infarto lagunar, Infarto Lacunar, accidente cerebrovascular lacunar, infarto lacunar (trastorno), infarto lacunar, Infarto lacunar, infarto lagunar (anomalía morfológica), infarto lacunar (anomalía morfológica) |
| English | lacunar infarction, lacunar infarction (diagnosis), infarcts lacunar, lacunar infarct, lacunar infarctions, infarction lacunar, Lacunar Infarctions, Infarction, Lacunar, Lacunar Infarction, Lacunar Infarcts, Infarct, Lacunar, Lacunar Infarct, INFARCT LACUNAR, Infarctions, Lacunar, Infarcts, Lacunar, LACI - Lacunar infarction, LI - Lacunar infarction, Lacunar infarct, Lacunar infarction, Lacunar infarct (morphologic abnormality), Lacunar infarction (disorder) |
| Czech | Lakunární infarkty |
| Hungarian | Lacunaris infarctus |
| French | Infarctus lacunaire, Infarctus lacunaires |
| Portuguese | Infarto Lacunar, Enfarte lacunar |
| Italian | Infarto lacunare |
| German | Hirninfarkt, lakunaerer, Hirninfarkt, lakunärer, Lakunaerinfarkt |
| Norwegian | Lakunært infarkt, Lakunært hjerneinfarkt |
| Dutch | lacunair infarct |
Ontology: Pure motor lacunar infarction (C0393957)
| Concepts | Disease or Syndrome (T047) |
| ICD10 | G46.5 |
| SnomedCT | 195214006, 230699008 |
| German | Rein motorisches lakunaeres Syndrom |
| Korean | 순수 운동성 열공 증후군 |
| English | pure motor lacunar syndrome (diagnosis), Pure motor lacunar syndrome, Pure motor lacunar infarction, Pure motor lacunar infarction (disorder), pure motor lacunar; syndrome (manifestation), syndrome; pure motor lacunar (manifestation) |
| Dutch | syndroom; zuiver motorisch lacunair, zuiver motorisch lacunair; syndroom, Zuiver motorisch lacunair syndroom |
| Spanish | infarto lacunar motor puro (trastorno), infarto lacunar motor puro |
Ontology: Pure sensory lacunar infarction (C0393958)
| Concepts | Disease or Syndrome (T047) |
| ICD10 | G46.6 |
| SnomedCT | 195215007, 230700009 |
| English | Pure sensory lacunar infarct, pure sensory lacunar syndrome (diagnosis), Pure sensory lacunar infarction, Pure sensory lacunar syndrome, Pure sensory lacunar infarction (disorder), pure sensory lacunar; syndrome (manifestation), syndrome; pure sensory lacunar (manifestation) |
| German | Rein sensorisches lakunaeres Syndrom |
| Korean | 순수 감각성 열공 증후군 |
| Dutch | syndroom; zuiver sensorisch lacunair, zuiver sensorisch lacunair; syndroom, Zuiver sensorisch lacunair syndroom |
| Spanish | infarto lacunar sensitivo puro (trastorno), infarto lacunar sensitivo puro |
Ontology: Pure sensorimotor lacunar infarction (C0393959)
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 230701008 |
| English | Pure sensorimotr lacun infarct, Pure sensorimotor lacunar infarction, Pure sensorimotor lacunar infarction (disorder) |
| Spanish | infarto lacunar sensoriomotor puro (trastorno), infarto lacunar sensoriomotor puro |
Ontology: Lacunar ataxic hemiparesis (C0393960)
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 230702001 |
| English | lacunar ataxic hemiparesis (diagnosis), Lacunar ataxic hemiparesis, Lacunar ataxic hemiparesis (disorder) |
| Spanish | hemiparesia atáxica lacunar (trastorno), hemiparesia atáxica lacunar |
Ontology: Dysarthria-clumsy hand syndrome (C0393961)
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 230703006 |
| English | Dysarthria-clumsy hand syndr, dysarthria - clumsy hand syndrome, dysarthria - clumsy hand syndrome (diagnosis), stroke - lacunar syndrome dysarthria - clumsy hand, Dysarthria-clumsy hand syndrome, Dysarthria-clumsy hand syndrome (disorder) |
| Spanish | disartria - síndrome de manos torpes (trastorno), disartria - síndrome de manos torpes |
