Patient presents with clinical findings consistent with lacunar stroke syndrome.  Onset of symptoms occurred approximately [time] prior to presentation.  Symptoms include [list specific symptoms e.g., pure motor hemiparesis, ataxic hemiparesis, dysarthria clumsy hand syndrome, pure sensory stroke, mixed sensorimotor stroke].  Neurological examination reveals [detailed neurological exam findings including affected side, muscle strength grading, sensory deficits, presence or absence of reflexes, coordination assessment].  Patient denies [relevant negatives e.g., headache, visual disturbance, loss of consciousness].  Medical history significant for [list relevant medical history e.g., hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, smoking]. Current medications include [list current medications].  Brain imaging (MRI brain with DWI and ADC sequences) is recommended to confirm the diagnosis of lacunar infarct and rule out other etiologies.  Initial differential diagnosis includes lacunar stroke, ischemic stroke of other subtypes, transient ischemic attack, and other neurological conditions mimicking stroke.  Blood pressure is [blood pressure reading] and heart rate is [heart rate].  Management plan includes [mention specific treatment plan e.g., blood pressure control, antiplatelet therapy with aspirin or clopidogrel, statin therapy for secondary stroke prevention, assessment for modifiable risk factors, referral to neurology, physical therapy, occupational therapy, speech therapy as needed]. Patient education provided regarding stroke risk factors, symptoms, and importance of medication adherence.  Follow-up scheduled with neurology in [duration] to reassess clinical status and adjust management as necessary.  ICD-10 code I63.8 (Other lacunar infarction) is considered pending imaging confirmation.