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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The clinical presentation of lacunar infarcts is variable and depends upon the size of infarct, the site, and the underlying cause.

Miller-Fisher has described several distinct syndromes:

  • pure motor hemiplegia - occurs in 60% of cases; due to a lesion in the posterior limb of the internal capsule

  • pure hemisensory stroke - occurs in 10% of cases; due to lesion in the thalamus

  • dysarthria with facial weakness and contralateral clumsy hand - occurs in 20% of cases; due to lesion in the pons

  • ipsilateral ataxia in the arm or leg, accompanied by leg weakness - rare; due to lesion in the pons

  • severe dysarthria with facial weakness - rare; due to lesion in the anterior limb of the internal capsule

  • dementia, pseudobulbar palsy and shuffling gait - due to multiple lacunar infarcts; may be confused with parkinsonism; more prevalent in patients with uncontrolled hypertension

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