Lacunar cerebral infarction is a special type of cerebral infarction and the mildest type of cerebral infarction, which is an occlusion of tiny arteries in the deep brain, usually deep penetrating branches or branch arteries (2-20 mm in diameter, some data suggest 5-15 mm) , 3/4 of patients have no obvious symptoms of focal neurological impairment The diagnosis of the disease is made by CT or a CT scan. The diagnosis of the disease is mainly based on CT or MRI examination. Infarct foci are mostly located in the deep brain, such as the white matter, internal capsule, basal ganglia, thalamus, brainstem and 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 to stabilize plaque and control blood sugar. 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 In patients with large and severe infarcts, dehydrating agents or diuretics and edaravone can be used (both mannitol and edaravone have the effect of scavenging free radicals). 2. Improve microcirculation and nourish brain cells Low-molecular dextrose is available, which can reduce blood viscosity and improve microcirculation. Butylphthalide, cytidylcholine, brain activator, ganglioside, etc. can be applied. 3. blood dilution ① equal volume hemodilution therapy: through intravenous blood release, at the same time to replace an equal amount of fluid; ② high volume hemodilution therapy: intravenous injection of fluid without blood to achieve the purpose of volume expansion. This method is rarely used in clinical practice. 4. Thrombolysis and fibrin degradation The infarct foci of lacunar cerebral infarction are relatively small, and thrombolysis is mostly not advocated, because thrombolysis itself is risky, and can be considered within 6 hours if the symptoms progress for a short time. The method is equivalent to cerebral thrombosis. ①Urokinase, which has been commonly used clinically. ②Recombinant human tissue-type fibrinogen activator (rt-PA), commonly used dose is 0.9mg/kg each time, of which 10mg is injected intravenously within 1-2 minutes, and 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 high price and the lack of Chinese clinical Due to the high price and the lack of clinical data of Chinese people, the dosage is for reference only. Fibrin-lowering drugs such as bactrim, fibrin-lowering enzymes (optional when fibrinogen is high) 5. anticoagulation, anti-platelet aggregation used to prevent the extension of thrombosis and new thrombosis. Heparin sodium, low-molecular heparin calcium, bye aspirin, clopidogrel, tirofiban, etc., can be used. The application of vasodilators and herbal medicines can sometimes aggravate the disease in severe patients with increased intracranial pressure, and their use is not recommended in the early stage. Western medicine can be chosen: Ozagrel, vincristine, Guipizide; Chinese medicine can be chosen: Haematoxylin, Danshen, Chuanxiongzin, Ginkgo biloba, Safflower, Gekisin, etc. 7. Other hyperbaric oxygen therapy, extracorporeal counterpulsation therapy and photometric blood therapy can also be used for this disease.