Clinical Conference Lacunar Stroke Principal Discussant

A 37-year-old, right-handed, monogamous homosexual white man was transferred to the Massachusetts General Hospital in December 1984, following admission to another hospital 8 days previously. On the day of his initial admission he had noticed the sudden onset of left-sided facial numbness and, within seconds, numbness of the left arm and leg leading to difficulty in controlling his leg movements with walking. An electroencephalogram, echocardiogram, and computed tomographic (CT) scan performed shortly after admission were normal. Within 12 hours the left-sided facial numbness resolved, by 36 hours the left arm was no longer numb, and by 72 hours the sensation in the left leg was normal. During the following days he noted the waxing and waning of a "coldness" of the left arm.