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Stroke

Lacunar infarction

07/07/2008

Question:

Do I have a lacunar infarction? I am right handed. My right arm, hand, leg is weak. My right eye is blurry, also. I have a pain at the base of head that continues down my neck and right shoulder, under my arm to my wrist. The pain is on the right upper chest and is felt through my back tricep. My fingers were numb 10 days ago. My blood pressure was very high 177/97 five days ago.

Answer:

A “lacunar infarct” is a small area of damage in the deep structures of the brain. Often this can involve the fiber tract that controls movement as it descends from the surface of the brain down to the spinal cord, leading to weakness of the face, arm, and leg on one side of the body. These symptoms are consistent with a lacunar infarct, which is often related to uncontrolled hypertension (high blood pressure).

The other symptoms don’t really fit very well with a lacunar infarct (i.e. the pain and the blurry vision), but I’m not able to comment further without being able to talk to you in detail and perform a full physical exam. Certainly if you have not seen your local doctor about this, you need to do so ASAP. He/she will want to determine what has happened and why it happened. If it is a lacunar stroke, they’ll want to take action to prevent any further stroke and will want to get your blood pressure under better control. Finally, but very importantly, if you’ve had a stroke you will likely benefit from physical, occupational, and speech therapy and the sooner you start, the better.

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Response by:

Brett   Kissela, MD Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati