Lacunar Stroke

A stroke in deeper structures underneath the cortex of the brain is called a lacunar stroke. Lacunar strokes tend to occur in patients with diabetes, hyperlipidemia, smoking or chronic hypertension and may be clinically silent or present as pure motor hemiparesis, pure sensory loss, or a variety of well-defined syndromes Lacunar stroke is usually due to a small vessel disease (SVD), commonly associated with hypertension, but it may have a more complex etiology.


Our data suggest a different prevalence of risk factors in patients with lacunar stroke due to SVD compared with lacunar stroke due to non-SVD. No significant differences in outcome were found between the two groups. Lacunar strokes account for about 20% of all strokes in the United States.

Unlike strokes that damage the cortex, lacunar strokes are only rarely caused by a blood clot that forms elsewhere in the body, such as the neck or heart, and travels through the bloodstream to the brain. Lacunar strokes have a much more favorable prognosis than nonlacunar strokes. The prognosis for recovery with lacunar stroke is better than with large artery territory stroke, and for this reason many centers favor using antiplatelet therapy (aspirin, clopidogrel) or conservative management rather than thrombolytic therapy for uncomplicated lacunar stroke.

Symptoms of Lacunar Stroke

Symptoms can include:

  • Weakness or paralysis of the face, arm, leg, foot or toes
  • Sudden numbness
  • Difficulty walking
  • Difficulty speaking
  • Clumsiness of a hand or arm
  • Weakness or paralysis of eye muscles
  • Other neurological symptoms