Stroke is acute episode of a focal neurological deficit lasting more than 24 hours presenting as sudden loss of neurological function caused by an interruption of the blood flow to the brain. Stroke may be ischaemic or haemorrhagic. The haemorrhagic stroke is mostly due to a sudden collapse or secondary trauma of the blood vessels or aneurysm. The stroke of the adult population is a chronic, serious disease. Stroke is the second leading cause of death and adult disability worldwide, and is a global health concern. Infarct of Lacunar in depths of the brain or brain stem are small ischaemic lesions.The lacunar type is a quarter of any ischaemic stroke. A 62 years old female who was a known case of diabetes mellitus, hypertension and some psychiatric illness and was on medication for 2 years, was referred from private hospital with chief complaints of multiple episodes of vomiting and altered sensorium since 2 days.

She had weakness in right upper and lower limbs withpain in the right shoulder , aphasia , disturbed balance, coordination and cognition. MRI and CT- SCAN was done. MRI brain revealed Acute lacunar infarcts in bilateral cerebral peduncles, pons, might middle cerebellar peduncle and right cerebellar hemisphere. Also ischemic changes in small vessels were noted. Therapeutic interventions:Medicinal interventions were done primarily followed by physiotherapy interventions which included ice-stroking and functional electrical stimulation to the right side. For left side, active assisted exercises were given. Improvement in muscle tone, strength and balance were reported after successful physical therapy. This case report provides a comprehensive weekly rehabilitation protocol for a patient to gain basic ADLs. Outcome measures were markedly improved with regular exercise and rehab protocol.