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This is sometimes considered a variant of ataxic hemiparesis (above) but is usually still classified as a distinct lacunar stroke syndrome. It usually affects the foot and leg more than it does the hand and arm hence, it is known also as 'homolateral ataxia and crural paresis'.

It displays a combination of cerebellar and pyramidal hemiparesis on the contralateral side of the body. This is the second most common lacunar syndrome and usually occurs with infarction of the posterior limb of the internal capsule, basis pontis, or corona radiata. It is characterized by contralateral hemiparesis that typically affects the face, arm, or leg in approximately equal measure, usually in a 'pyramidal' pattern. This is the most common (33-50%) lacunar syndrome and usually occurs with infarction of the posterior limb of the internal capsule, which carries the descending corticospinal and corticobulbar tracts, or the basis pontis. The five classic syndromes are as follows: Pure motor stroke/hemiparesis agraphaesthesia, loss of two-point discrimination, loss of joint position sense, astereognosis). Unlike cortical strokes, patients with lacunar stroke syndromes do not exhibit any cortical signs such as aphasia, agnosia, sensory neglect or extinction, apraxia, visual field defects, or cortical sensory loss (e.g. the capsular warning syndrome, see transient ischemic attack). Symptoms may occur suddenly, progressively, or in a fluctuating manner (e.g. Lacunar stroke syndrome is a description of the clinical syndrome that results from a lacunar infarct.Įach of the five classical lacunar syndromes has a relatively distinct symptom complex.