Lacunar Stroke

Overview

Lacunar strokes are a type of ischaemic stroke caused by the blockage of small arteries deep within the brain. Although typically smaller in size, these strokes can lead to specific and disabling neurological syndromes that affect movement, speech, and coordination.

At The Royal Buckinghamshire Hospital, we provide consultant-led inpatient neurorehabilitation for adults recovering from lacunar stroke. Our specialist team supports physical, cognitive, and emotional recovery in a calm, private environment.

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What Is a Lacunar Stroke?

A lacunar stroke occurs when blood flow through one of the brain’s small, deep arteries is interrupted—typically due to small-vessel disease, a form of chronic damage to the blood vessel walls.

These strokes usually affect areas such as the:

• Basal ganglia
• Thalamus
• Internal capsule
• Pons

Though often less dramatic than larger strokes, lacunar strokes can still result in significant loss of function and may increase the long-term risk of vascular dementia or additional strokes.

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Causes and Risk Factors

Lacunar strokes are most commonly associated with:

• Chronic high blood pressure (hypertension)
• Diabetes mellitus
• Smoking
• High cholesterol
• A history of previous strokes or TIAs
• Small-vessel disease or cerebral microangiopathy

The damage to blood vessel walls leads to narrowing or occlusion, often without major artery involvement.

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Common Lacunar Stroke Syndromes

There are several well-recognised lacunar syndromes, each with distinct clinical features. These include:

• Pure motor stroke: Weakness on one side of the body without sensory loss.
• Pure sensory stroke: Numbness or tingling on one side of the body.
• Sensorimotor stroke: Combined weakness and sensory changes on the same side.
• Ataxic hemiparesis: Weakness and poor coordination, particularly affecting walking.
• Dysarthria–clumsy hand syndrome: Slurred speech with hand or arm clumsiness.

These symptoms can range from mild to severe and may impact everyday activities such as walking, dressing, eating, or speaking.

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Diagnosis

Diagnosis involves a combination of:

• Neurological examination
• MRI brain scan to detect small, deep infarcts
• CT scan (less sensitive for small strokes but may still be used)
• Cardiac and vascular investigations to rule out embolic causes
• Blood pressure and cholesterol monitoring

Lacunar strokes may not always be visible immediately on imaging, so clinical assessment is vital.

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Inpatient Stroke Rehabilitation at The Royal Buckinghamshire Hospital

Our stroke rehabilitation programme supports adults recovering from lacunar stroke syndromes. We create an individualised care plan that addresses mobility, speech, cognition, and psychological wellbeing.

Our specialist team includes:

Physiotherapy

• Strength and balance training
• Gait re-education
• Upper limb rehabilitation
• Functional mobility exercises

Occupational Therapy

• Support with dressing, washing and eating
• Hand coordination training
• Fatigue and routine management
• Visual and spatial rehabilitation (if affected)

Speech and Language Therapy

• Support for dysarthria or slurred speech
• Language and cognitive-communication strategies
• Swallowing assessments (if needed)

Neuropsychology

• Emotional support and adjustment to stroke
• Memory, attention and planning strategies
• Coping mechanisms for frustration or low mood

Specialist Nursing

• Blood pressure and medication management
• Skin care, continence and nutrition support
• Monitoring for complications or secondary symptoms

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Who We Support

We care for adults (18+) who:

• Have had a confirmed or suspected lacunar stroke
• Are experiencing weakness, clumsiness, speech or sensory problems
• Need coordinated rehabilitation in a structured inpatient setting
• Are motivated to improve mobility, independence and communication

To learn more, call 01296 678800 or enquire online.

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Why Choose The Royal Buckinghamshire Hospital?

• Extensive experience in complex stroke rehabilitation
• Consultant-led inpatient programmes
• Therapies delivered up to 7 days per week
• Quiet, private environment for focused recovery
• Strong support for families and long-term planning