14. Pons, Remote Lacunar Infarct - Gross
The fact that this infarct is cystic indicates that it is remote, or
older than 6 months. "Lacunar" infarcts usually surround a small
artery or arteriole and are small areas of parenchymal destruction in
the setting of long-standing hypertension. Lacunar infarcts are most
commonly found in the basal ganglia and pons. A lacunar infarct in
this patient's right basal ganglia, especially if it involved the
internal capsule, could have resulted in the profound left arm and
leg weakness the year prior to his death. The edema surrounding an
acute infarct makes acute symptoms worse. As the edema resolves, the
symptoms improve, sometimes with complete clinical resolution.
