Stroke, Vol 25, 2005-2009, Copyright © 1994 by American Heart Association
I Clavier, M Hommel, G Besson, B Noelle and JE Perret
BACKGROUND AND PURPOSE: This study concerns the long-term prognosis of
lacunar infarcts. METHODS: We report the analysis of our hospital-based
series of 178 patients consecutively admitted for a lacunar syndrome due to
a lacunar infarct diagnosed with computed tomography and magnetic resonance
imaging. Demographic data, medical history, vascular risk factors, and
imaging data were recorded for each patient. The follow-up was 35 +/- 22
months. RESULTS: The lacunar syndrome was pure motor hemiparesis in 69
patients (39%), ataxic hemiparesis in 45 patients (25.4%), pure sensory
stroke in 15 patients (8.5%), sensorimotor stroke in 14 patients (7.9%),
and miscellaneous syndrome in 34 patients (19.2%). The 4-year survival rate
was 80 +/- 4% and the 4-year survival rate without recurrent stroke was 85
+/- 3.5%. Using Cox proportional-hazards analysis, the predictors of death
were age (P < .02), diabetes mellitus (P < .05), and cigarette
smoking (P < .05). We did not find any predictors of recurrence. After 1
year, 74% of the patients had mild or no disability. Using logistic
regression analysis, the predictive factors of disability were age more
than 70 years (P < .01), diabetes (P < .01), history of stroke or
transient ischemic attack (P < .05), and type of lacunar syndrome (P
< .01). Imaging data, number of lacunes, and presence of leukoaraiosis
were not predictors of outcome. CONCLUSIONS: Our study suggests that with a
high survival rate, a low recurrence rate, and a relatively good functional
recovery, lacunar infarcts have a relatively favorable prognosis.
ARTICLES
Long-term prognosis of symptomatic lacunar infarcts. A hospital-based study
Stroke Unit, Clinique Neurologique, Department of Clinical and Biological Neurosciences, Grenoble, France.
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