Lacunar infarcts may manifest all of the following except:
Correct Answer: Quadriparesis
Description: Answer is D (Quadriparesis): Quadriparesis or Quadriplegia are not associated with lacunar infarcts. Lacunar Infarcts Lacunar infarcts are small vessel strokes caused by occlusion of a single penetrating aery that supplies one of the deep structures in brain such as the internal capsule, corona radiate, basal ganglia, thalamus and brainstem. These are usually caused by Lipohyalinosis of penetrating aeries from longstanding hypeension, atherosclerosis or diabetes Several distinct syndromes are associated with lacunar infarcts. Distinct clinical syndromes associated with lacunar infarcts. Pure motor Hemiparesis Most common lacunar syndrome Results from infarction of contralateral internal capsule (may also be seen with infarcts in corona radiate and pons) The face, arm and leg are equally affected There is no sensory loss, homonymous hemianopia, Aphasia or hemineglect Pure sensory stroke Infarction almost always involves the thalamus Sensory loss is present throughout the contralateral side, but various paial hemisensory syndrome can occur. Sensation is usually decreased for all sensory modalities, and no other neurologic deficits are present. Patient often complains of abnormal spontaneous sensation, such as "pins-and?needles" or skin tightness. Sensorimotor stroke Infarcts involve both internal capsule and thalamus Ataxic Hemiparesis Contralateral weakness and limb ataxia Weakness and ataxia present on the same side with the ataxia usually more severe than the weakness. Most commonly occurs in the pons, the internal capsule or the corona radiata Dysahria Clumsiness Syndrome Prominent dysahria and ataxia of the upper limb Facial weakness, dysphagia and varying degrees of weakness in the arm and leg Associated with infarction in the internal capsule or the pons.
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