Dizziness and drooling should be considered in the elderly due to multiple cerebral infarcts or ischemia in the posterior circulation. If dizziness and lethargy are accompanied by clumsy speech, drooling or choking on water, numbness and weakness in the lateral limbs, consider whether brainstem infarction is present and prompt head MRI should be performed. If it is just dizziness, drooling, slow reaction, and diminished calculation, memory or other intellectual functions, previous hypertension, diabetes, etc., combined with previous medical history of multiple cerebral infarcts, consider the intellectual impairment brought by multiple lacunar infarcts later. After reviewing head imaging, if there is no new brainstem infarct or new infarcts in other locations, consider the lacunar state. This condition is milder than brainstem infarction, but at the same time, we should pay attention to further aggravation of infarction and need to strengthen oral medication for secondary prevention of cerebrovascular disease and consolidation treatment.