Stroke, Vol 23, 1434-1438, Copyright © 1992 by American Heart Association
S Miyao, A Takano, J Teramoto and A Takahashi
BACKGROUND AND PURPOSE: Close relations between leukoaraiosis detected by
computed tomography or magnetic resonance imaging and stroke, particularly
lacunar infarction, have been reported. We studied whether leukoaraiosis is
related to long-term prognosis for patients with lacunar infarction.
METHODS: We examined monthly 215 patients with lacunar infarction after
their first stroke. They comprised 95 patients with leukoaraiosis disclosed
by computed tomography on admission (58 men and 37 women; mean age, 71.3
+/- 9.0 years) and 120 patients without leukoaraiosis (81 men and 39 women;
mean age, 65.5 +/- 8.9 years). These patients had no previous history of
either stroke or obvious dementia before their index stroke. We compared
the prognosis with and without leukoaraiosis based on analysis of recurrent
stroke, survival, and the prevalence of dementia and rate of dependence in
activities of daily living. RESULTS: Life table analysis revealed that the
recurrent stroke rate was significantly higher in the patients with
leukoaraiosis than in those without it (p = 0.004). The prevalence of
dementia and rate of dependence in activities of daily living both 1 month
after the index stroke and at the end of the follow-up period were
significantly higher in the patients with leukoaraiosis (all parameters, P
less than 0.001). Their survival rate was significantly lower than in those
not suffering from leukoaraiosis (p = 0.012). Significant differences in
these comparisons were also observed after matching for age and sex.
CONCLUSIONS: The presence of leukoaraiosis as identified by computed
tomography indicates a poor prognosis for patients with lacunar infarction.
ARTICLES
Leukoaraiosis in relation to prognosis for patients with lacunar infarction
Department of Neurology, Meitetsu Hospital, Nagoya, Japan.
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