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Lacunar stroke is the most common type of ischemic stroke, resulting from the occlusion of small penetrating arteries; that provide blood to the brain's deep structures.

Infarcts involving the anterior portion of the medial pons can produce dysarthria and contra-lateral hemiparesis. lower facial palsy due to disruption of the ipsilateral corticospinal and corticobulbar tracts. The trigeminal nerve arises at the level of the middle cerebellar peduncle at the lateral aspect of the mid-pons.

The trigeminal nerve exits the brainstem at the lateral aspect of the mid-pons at the level of the middle cerebellar peduncles. (a key neuro-anatomic landmark for locating the nerve).
The trigeminal sensory nuclei (for example, principal sensory, spinal, mesencephalic) run from the midbrain to the upper cervical spine, and receive afferent signals for facial sensation via all 3 nerve branches (ophthalmic, maxillary, and mandibular).
The trigeminal motor nucleus is located in the lateral mid-pons and sends efferent signals to the muscles of mastication (for example, temporalis, masseter, terygoids) via the mandibular branch.

Infarcts involving the anterior pons can affect the corticospinal tract (contralateral hemiparesis, Babinski sign), and corticobulbar tract, (contralateral lower facial palsy, dysarthria).

Disruption of the corticopontine fibers that convey motor information from the cortex to the ipsilateral pontine gray matter may also result in contralateral dysmetria and dysdiadochokinesia (ataxic hemiparesis).

The cerebellar deficits are contralateral to the lesion as the pontocerebellar fibers arising from the pontine gray matter decussate, and enter the cerebellum through the contralateral middle cerebellar peduncle.

By Prashanthsaddala - Lacunar-infarction-001.jpg at WikiDoc (CC-BY-SA-3.0), CC BY-SA 3.0, https://commons.wikimedia.org/w/index...

By Patrick J. Lynch, medical illustrator - Patrick J. Lynch, medical illustrator, CC BY 2.5, https://commons.wikimedia.org/w/index...

By OpenStax College - Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, https://commons.wikimedia.org/w/index...

By BodyParts3D is generated by DBCLS - Polygon data is from BodyParts3D by DBCLS, CC BY-SA 2.1 jp, https://commons.wikimedia.org/w/index...

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