Objective Toinvestigatethechangesofcognitiveimpairmentandcerebralhemodynamics inpatientswithacutelacunarcerebralinfarctionwithin2weeksafteronset.Methods Nineteenpatients with lacunar cerebral infarction (a patient group)were consecutive enrolled in the study. Twenty-three sex-and age-matched inpatients without ischemic cerebrovascular disease or healthy volunteers of outpatient department over the same period were used as a control group. The cerebral hemodynamic features were evaluated with transcranial Doppler (TCD)breath-holding test and single photon emission computed tomography (SPECT)resting + adenosine stress imaging. Simultaneously,the neuropsychological tests were performed,the Montreal cognitive assessment (MoCA)was performed including executive capacity, structural capacity,memory (including auditory memory,visual memory,and logic memory ),information processing speed,and visual-spatial ability. Results (1 )There were no significant differences in the years of education,hypertension,diabetes,hyperlipidemia,coronary heart disease,and smoking between the 2 groups (all P>0. 05). Compared with the control group,there were significant differences in the MoCA score,visual memory,executive function,structural capacity,and information processing speed of the patient group (all P<0. 05). (2)19 patients completed the SPECT resting + load test (12 in the control group and 7 in the patient group). There were significant differences in the uptake ratio (UR)in the right basal ganglia (8. 91[-2. 48 - 5. 87]and -6. 21 [-10. 39 - 5. 42 respectively])and left frontal lobe UR (11. 62 [2. 93-16. 87]and 1. 04 [-10. 17- 3. 82]respectively)between the patient group and the control group (P<0. 05). (3)26 patients completed the breath-holding test + head-up tilt table test (n=13 in each group]. The vascular motor reactivities were 13 ± 5 on the left and 21 ± 7 on the right, and the breath-holding indexes were 0. 66 ± 0. 26 on the left and 1. 0 ± 0. 4 on the right in the patient group;the vascular motor reactivities were 24 ± 11 on the left and 30 ± 9 on the right,and the breath-holding indexes were 1. 21 ± 0. 57 on the left and 1. 5 ± 0. 4 on the right in the control group. There were significant differencesbetweenthe2groups(P<0.05).Conclusion Attheearlystageoflacunarinfarction,the patients have presented varying degrees of cognitive impairment and the changes of cerebral hemodynamics.