What does a lacunar infarct primarily result from?

A lacunar infarct primarily results from small vessel disease. This type of infarct occurs when small penetrating arteries that supply deep structures of the brain, such as the basal ganglia and thalamus, become occluded. Small vessel disease is often associated with chronic conditions like hypertension and diabetes, which can cause lipohyalinosis and subsequent narrowing or blockage of these smaller vessels.

Lacunar infarcts are typically 1 to 15 mm in size and can lead to specific types of neurological deficits depending on the area of the brain that is affected. Because they occur due to the occlusion of these small penetrating vessels rather than larger cerebral arteries, the correct understanding of their etiology emphasizes the role of small vessel disease in the pathophysiology of lacunar strokes. This highlights how critical managing risk factors such as blood pressure control is in preventing these types of strokes.