What is multiple lacunar cerebral infarction?

  Multiple lacunar cerebral infarction belongs to a kind of cerebral infarction, which refers to small penetrating arteries in the cerebral hemispheres or deep brainstem, and on the basis of long-term hypertension, lesions occur in the vessel wall, resulting in the occlusion of the official lumen to form small infarct foci, which are shown as cystic lesions of 0.2~15mm in diameter on head CT or head MRI.  Lacunar cerebral infarction is mostly seen in middle-aged and elderly people, with a long-term history of hypertension, acute or gradual onset, generally without headache or impaired consciousness, and four types are more common clinically: (1) pure motor light hemiparesis, which is the most common type, accounting for about 60%, manifested by ipsilateral distortion of the mouth and tongue and unfavorable limb movement; (2) dysarthria-hands clumsiness syndrome, accounting for about 20%, manifested by unclear speech, difficulty in swallowing, and lesion on the body. (2) Dysarthria-hand clumsiness syndrome, accounting for about 20% of cases, manifesting as unclear speech, dysphagia, lateral paralysis on the opposite side of the lesion, mild hand weakness and fine motor impairment; (3) Pure sensory stroke, accounting for about 10% of cases, manifesting as hemianesthesia; (4) Ataxic mild hemiparesis, manifesting as unfavorable limb movement on one side and ataxic motor instability, often with the lower limb more than the upper limb. The prognosis of lacunar cerebral infarction is good, and the death and disability rates are low, but it is easy to recur, so it is extremely important to prevent recurrence of the disease. The lacunar infarct foci detected by routine head CT examination are not clinically significant if they are asymptomatic, probably because the infarct foci do not affect functional areas or have good vascular compensation.  In conclusion, although the prognosis of lacunar cerebral infarction is good, it is still necessary to pay attention to the control of risk factors such as hypertension, hyperglycemia and hyperlipidemia, quit smoking and alcohol, moderate physical exercise and reasonable diet, etc. to prevent recurrence.