Lacunar infarcts affect the deep penetrating vessels of the middle cerebral artery and carry the best prognosis of all strokes.
There are 4 classic syndromes characteristically caused by lacunar infarcts, with which the emergency physician should be familiar and able to recognize. They are:
Pure motor hemiparesis.
Pure sensory syndrome.
Ataxic hemiparesis (ipsilateral cerebellar and motor symptoms).
Clumsy hand dysarthria syndrome (ipsilateral hand weakness, patient may say their hand "feels awkward," dysarthria more pronounced than the weakness).
