In L’etat lacunaire, or lacunar state, the brain contains multiple small infarcts or lacunes, usually in the deep structures, especially the basal ganglia.
Similar to lacunar strokes, the lacunar state is associated with hypertension and atherosclerosis, the latter being present especially in the small deep vessels in the brain. Many small infarcts can result in dementia, characterized by loss of recent memory, alterations in orientation to time and space, and occasionally paranoia. Lacunar state is a common cause of vascular dementia. There also can be headache, vertigo, and light-headedness. Sensory loss and motor deficits such as ataxia, hemiparesis, and dysarthria, may occur, presenting similarly to lacunar stroke syndromes. Although the diagnosis can be made on clinical grounds, CT scanning and magnetic resonance imaging usually clearly demonstrate the multiple small cerebral infarctions.