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(Stroke. 1995;26:2023-2026.)
© 1995 American Heart Association, Inc.

Articles

Functional Outcome for Patients With Hemiparesis, Hemihypesthesia, and Hemianopsia

Does Lesion Location Matter?

Alexander W. Dromerick, MD Michael J. Reding, MD

From Cornell University Medical College at Burke Rehabilitation Hospital, White Plains, NY.

Correspondence to Alexander Dromerick, MD, Department of Neurology, Washington University School of Medicine, Campus Box 8111, 660 S Euclid St, St Louis, MO 63110. E-mail awd3034@bjcmail.carenet.org.

Background and Purpose Patients with hemiparesis, hemisensory loss, and hemianopsia ("HHH" deficits) due to stroke may have large cortical lesions caused by middle cerebral trunk vessel occlusion or smaller subcortical lesions due to lenticulostriate involvement. We studied the usefulness of lesion location in predicting functional recovery within this syndrome.

Methods We reviewed our records and found 41 patients who had a single ischemic hemispheric stroke, HHH deficits, and an available CT scan performed more than 24 hours after the onset of symptoms. CT scans were read independently and blindly by the authors. Lesions were initially categorized by arterial distribution on the basis of CT templates published by Kinkel. The numerous combinations of arterial branch vessel occlusions observed did not allow for statistical analyses because of the small number of subjects within each subgroup. Lesions were therefore classified as cortical (C), subcortical (S), or mixed (M).

Results There were no significant differences among the three anatomic groups for age, sex, interval after stroke, Mini-Mental Status Examination score, or admission Barthel Index score. Functional outcome measures did not differ significantly for the three groups: mean±SD discharge Barthel score (C, 64±31; S, 47±20; M, 57±21), length of stay ([days] C, 64±25; S, 77±24; M, 73±28), and frequency of nursing home placement (C, 4/8; S, 3/6; M, 2/16).

Conclusions For patients with HHH deficits, the anatomic location of the lesion (C versus S versus M) does not affect functional outcome.

Key Words: cerebrovascular disorders • outcome • rehabilitation • tomography, x-ray computed

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