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Lacunar infarcts are small infarcts in the basal ganglia, thalamus, white matter and in the brain stem all of which constitute the deeper parts of the brain. Yes, an old infarct can cause stroke, if there is an additional damage in surrounding area. More than the chance of a stroke, old lacunar infarcts can result in dementia or damage to the white matter of the brain.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!
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