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A 57 year-old man with poorly controlled hypertension presented with symptoms of weakness involving the left face and body.
MRI axial images - T2 (left) and Flair (right): Note the well-demarcated ischemic stroke in the region of the posterior limb of the right internal capsule/ This type of stroke is caused by occlusion of the deep perforating blood vessels (also known as small vessel disease or lacunar strokes). Small vessel disease is most commonly associated with hypertension and diabetes. There are several classic lacunar syndromes, including pure motor hemiparesis, ataxic hemiparesis, clumsy hand-dysarthria (lesions either in the internal capsule or basis pontis) and pure sensory stroke (lesion in the thalamus).
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