STROKE-PRESENTATION, LACUNAR INFARCT
SUMMARY
Occlusive arteriolar or small artery disease leading to small lesions in the putamen, pons, thalamus, caudate, internal capsule:
1. 23% with preceding TIA & strong correlation with HTN[1]
PRESENTATION
2. Pure hemiplegia (with no sensory dysfunction): lesion in the posterior limb of the internal capsule/lower pons[2]
3. Pure hemisensory stroke (with no motor dysfunction): lesion in the sensory nucleus of the thalamus[3]
4. Sensory motor stroke
5. Ataxic hemiparesis (ataxia ipsilateral to hemiparesis): lesion in the upper pons[4]
6. Clumsy hand-dysarthria syndrome: lesion in the upper pons[5]
7. Multiple bilateral frontal lobe lacunae can result in pseudobulbar palsy-emotional lability with uninhibited crying or laughter and UMN signs (brisk jaw jerk, hyper-reflexia, and Babinski sign)
Reference(s)
- ↑ Fisher CM. Lacunar stroke and infarcts- a review. Neurology 1982; 32: 871-876.
- ↑ Fisher CM. Lacunar stroke and infarcts- a review. Neurology 1982; 32: 871-876.
- ↑ Fisher CM. Lacunar stroke and infarcts- a review. Neurology 1982; 32: 871-876.
- ↑ Fisher CM. Lacunar stroke and infarcts- a review. Neurology 1982; 32: 871-876.
- ↑ Fisher CM. Lacunar stroke and infarcts- a review. Neurology 1982; 32: 871-876.
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
