Lacunar cerebral infarction is a special type of cerebral infarction, which is an occlusion of tiny arteries in the deep brain, often deep penetrating branches or branch arteries (2-20 mm in diameter. Some books are 5-15 mm). 3/4 of patients have no symptoms of focal neurological damage, or only have mild inattention, memory loss, mild headache dizziness, vertigo, unresponsiveness and other symptoms. The diagnosis of the disease is mainly CT or MRI examination. Infarct foci are mostly located in the deep part of the brain, such as the white matter of the brain, the internal capsule, the basal ganglia, the thalamus, the brainstem and the cerebellum. The treatment of this disease is basically the same as cerebral thrombosis, hypertension should be treated actively, especially those who have had lacunar infarction in their medical history need to prevent recurrence, lipid regulation and blood sugar control. Acute phase: The principle is to improve the blood circulation in the cerebral ischemic area and promote the recovery of neurological function as soon as possible. 1. Relieve cerebral edema and scavenge free radicals: for patients with large and severe infarcts, use dehydrating agents or diuretics and edaravone (both mannitol and edaravone have the effect of scavenging free radicals). 2.Improve microcirculation and nutrition of brain cells: low molecular dextrose can be used, which can reduce blood viscosity and improve microcirculation. Cerebrofacial, cytidylphosphorylcholine, cerebrolysin, gangliosides, etc. 3.Hemodilution: ① Isovolemic hemodilution therapy: blood is released through the vein and the same amount of fluid is replaced; ② High-volume hemodilution therapy: intravenous injection of fluid without blood to achieve the purpose of volume expansion. 4.Thrombolysis and degradation of fibrin: lacunar cerebral infarction, infarction small mostly does not advocate thrombolysis, thrombolysis itself is risky, if the symptoms have progressed for a short time, within 6 hours can be considered. ①Urokinase, which has been commonly used clinically. ②Recombinant human tissue-type fibrinolytic plasminogen activator (rt-PA), commonly used dose is 0.9mg/kg each time, of which 10mg is injected intravenously within 1-2 minutes, the rest of the dose is slowly dripped within 1.5 to 2 hours, some people advocate 8mg intravenous push, 42mg dripped within 1 hour, because of the expensive and lack of Chinese clinical Because of the high price and the lack of clinical data on Chinese people, the dosage is for reference only. Fibrin-lowering drugs such as bactrim, fibrin-lowering enzyme, etc. (optional when fibrinogen is high) 5, anticoagulation, anti-platelet aggregation: used to prevent thrombus extension and new thrombosis. Heparin sodium, low-molecular heparin calcium; Bayer aspirin, clopidogrel, etc., tirofiban, etc., can be used. 6, vasodilatation and the application of Chinese medicine: for serious patients with increased intracranial pressure, sometimes can aggravate the disease, ultra-early more is not advocated. Western medicine can be chosen: Ozagrel, hanging percocet; Chinese medicine can be chosen: hemosiderin, salvia, Chuanxiongzin, ginkgo biloba, safflower, geranium, etc. 7.Other: Hyperbaric oxygen therapy, extracorporeal counterpulsation therapy and photometric blood therapy can also be used for this disease.