On pure motor hemiplegia (Fisher's syndrome)

The authors described three cases of so-called "lacunar strokes" with pure motor hemiplegia. Clinical diagnosis in all three cases was middle cerebral artery thrombosis. In cases 1 and 2 small post-malacic lacunes were found in the basal part of the pons. In case 3 the lesion was located in the pyramidal tract within the pons and medulla. In all cases advanced arteriosclerotic changes were observed. "Lacunar stroke" can result from a lesion of both the pons and the medulla. The clinical syndrome may be engendered also by selective lesion of the pyramidal tract.