A lacunar infarct is a small infarction, or stroke, that is usually less than about 1 to 1.5 cm in size and typically occurs in deep cerebral structures (e.g. basal ganglia) of hypertensive or diabetic patients with small vessel disease of deep penetrating arteries (e.g. lenticulostriate arteries) . The gross impression of this brain, which belonged to a person with hypertension, was remarkable for a cystic space, called a “lacune”, in the caudate nucleus (lower left inset). On microscopic examination, evidence of a prior infarction is seen by the presence of macrophages, reactive astrocytes and gliosis that surround a small empty space. At one time, this space had been occupied by brain tissue, but, after infarction, macrophages removed dead brain tissue until only a cyst-like space remains.
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