Lacunar Infarction In Old Stroke: A Case Report

Introduction: Lacunar stroke accounts for nearly a quarter of all ischemic strokes and is an important cause of vascular cognitive impairment and dementia. Case Presentation: A 52-year-old man with lacunar infarct presented with weakness in his left thumb and forefinger since one day ago when he was sitting down.  The patient’s fingers appear bent as if holding a pencil and could not be straightened. Physical examination showed an high blood pressure, and paresis of the right facial and hypoglossal nerve. A non-contrast CT scan of head using the parenchymal window showed a hypodense lesion on the left pons, interpreted as a lacunar infarct. Discussion: Lacunar strokes represent approximately 25% of ischemic strokes and most are associated with good outcomes. However, in 20% to 30% of patients with lacunar stroke, early neurologic damage occurs within the first days after stroke onset. Lacunar stroke was defined as acute lacunar syndrome with infarction <15 mm in diameter in the basal ganglia, deep white matter, thalamus or pons that is not associated with large vessel atherosclerosis or a cardioembolic source. Conclusion: Lacunar infarction is a potentially reversible. These conditions can potentially be well managed with adequate treatment.