Many outpatients come to the clinic with a CT or MRI film of the head and a panicked face, saying they have a “stroke” or a “brain infarction” and asking the doctor to administer fluids and other treatments. Let’s talk about what is lacunar infarction and how to deal with it. A lacunar infarct is a very small infarct foci, usually less than 1.5 cm in diameter. This kind of infarction mostly occurs in the deep basal ganglia area of the brain and the brainstem and other areas. The arteries in these areas are mostly tiny arteries called deep penetrating branches, which are actually the terminal branches of the cerebral arteries, also known as the end branches. Because of the limited blood supply of deep penetrating arteries, blockage of a single artery only causes ischemic necrosis in a small area of brain tissue, which is called lacunar. The most common cause of lacunar cerebral infarction is still hypertensive atherosclerosis. In addition to those caused by microembolism, most of them are due to the degeneration of the blood vessel wall of small intracerebral arteries caused by the influence of long-term hypertension, which makes the lumen narrower and occlusion of small arteries occurs under some hemodynamic factors or induced by changes in blood composition. We are a country with a high prevalence of hypertensive disease, so this type of cerebral infarction is common. The deep basal ganglia region of the brain and the brainstem are important pathways for the travel of many nerve fiber bundles, which bridge the neural connections between the brain and the body. If a lacunar cerebral infarction occurs in these pathways, it can cause blockage of certain nerve conduction and produce symptoms in areas such as motor, sensory or speech impairment. Because the lacunae are small, sometimes they affect motor or sensory fibers alone, and pure motor hemiparesis occurs, or only hemianesthesia without hemiparesis occurs. However, not all lacunae that occur will produce symptoms; only those that involve important neural pathways or neural structures will manifest, or they can otherwise be asymptomatic. Effective control of hypertension and all types of cerebral atherosclerosis reduces the likelihood of lacunar stroke and is the key to preventing this disease. In people who do not have any symptoms and are normal on examination by a physician, a specific analysis should be made by the physician taking into account the film and the individual patient’s risk factors so that individualized measures for stroke 2 prevention can be developed. Do not have a blanket preconception that it is a cerebral infarction and immediately have to be treated with infusions and so on, or carry a heavy ideological workload and suffer from depression over time. Therefore, even if there are some mild neurological signs or symptoms, there is no need to worry because they do not cause serious harm. As long as preventive measures are taken carefully under the guidance of a doctor, the chance of recurrence can be reduced.