Two cases of pure sensory stroke were studied pathologically 6 mo. and 4 yr after the acute illness. In both, there were lacunar infarcts in the region of the sensory nucleus of the thalamus on the side opposite the symptoms. The responsible vascular lesion in each case was hypertensive lipohyalinotic cerebral angiopathy, a process that correlates with the presence of hypertension. This was the 1st time that a complete clinicopathologic investigation was possible in pure sensory stroke and also the 1st time a lipohyalinotic lesion was proven the cause of a specific clinical syndrome.