Name the symptoms associated with the five well recognized lacunar syndromes. Bonus points for localizing the infarct location.

More than 20 lacunar syndromes have been described. Five, those listed below, have been validated as being highly predictive for the presence of lacunes radiologically.

1. pure motor hemiparesis - unilateral face, arm, and leg weakness

2. pure sensory stroke - sensory loss to all primary modalities in the contralateral face and body

3. sensorimotor stroke - weakness and numbness of the face, arm and leg on one side of the body

4. dysarthria-clumsy hand - facial weakness, dysarthria, dysphagia and slight clumsiness of one hand

5. ataxic hemiparesis - same as pure motor hemiparesis but with ataxia on same side as weakness

As a general rule, lacunar syndromes lack "cortical" signs such as aphasia, agnosia (inability to recognize objects by touch alone), neglect, apraxia (inability to carry out purposeful voluntary movements which can't be explained by paresis or sensory loss ie difficulty putting clothes on) or hemianopsia. Lacunar infarcts have a better short term ( up to 1 year) prognosis than infarcts due to other stroke mechanisms.


Source

Blumenfeld, H. Neuroanatomy through Clinical Cases.

Oliveira, J. and Kistler, J. "Lacunar infarcts" Up to Date. 16 May 2009.