Occlusions of the lenticulostriate artery or penetrating branches of the Circle of Willis or vertebral or basilar arteries are referred to as lacunar strokes. About 20% of all stokes are lacunar and have a high incidence in patients with chronic hypertension.
Lacunar infarcts may have serious functional consequences if they involve motor or sensory fibers in the internal capsule, but may be 'silent' if they involve other small regions of white matter or the basal ganglia.
In the elderly, CT scanning shows signs of infarction in only approximately half of the most of the common form of lacunar stroke (pure motor stroke), but MRI has increased the yield: the probability that CT or MRI will be positive is generally a function of the severity of the deficit [Mohr JP and Sacco RL, 1992]. The cells distal to the occlusion die, but since these areas are very small often only minor deficits are seen. When the infarction is critically located, however, more severe manifestations may develop, including paralysis and sensory loss.
Within a few months of the infarction, the necrotic brains cells are reabsorbed by macrophage activity, leaving a very small cavity referred to as a lake (or lacune in French).
Is one of a pair of blood vessels that supply oxygenated blood to the posterior aspect of the brain (occipital lobe) in human anatomy. It arises near the intersection of the posterior communicating artery and the basilar artery and connects with the ipsilateral middle cerebral artery (MCA) and internal carotid artery via the posterior communicating artery (PCommA).
1) Stoke/Brain Attack reporter's Handbook. Englewood, Colo: National Stroke Association, 1995