Lacunar infarctions presenting as memory loss and mental changes: four cases report.

Impairment of higher cortical functions is usually not considered as a typical presentation of lacunar infarction. However, a small discrete lesion at strategically important locations may produce memory loss and mental changes. We report 4 patients with lacunar infarctions manifested as acute amnesia and mental changes. One patient had left thalamic infarction, one had left capsular genu infarction, one had right capsular genu infarction, and one had left capsular genu infarction extending to the ipsilateral thalamus. The mental and memory impairment was transient in one patient but was persistent in the other 3 patients. Our report reconfirms that a lacunar infarction can cause impairment of higher cortical functions.