Prognostic factors in stroke

Prognostic factors in 137 patients with acute ischaemic infarction of the cerebral hemisphere were examined in a prospective study with particular reference to acute mortality, delayed mortality and the ability to regain independent living. Adverse factors in the examination on admission to hospital with regard to all these aspects were found to be a reduction of the level of consciousness to any degree and paralysis of conjugate gaze. A severe hemiplegia and advancing age indicated a bad prognosis for delayed mortality and severe disability in survivors, but did not affect acute mortality. At three weeks after the onset, inability to walk unaided, a useless hand and or urinary incontinence was associated with an increased probability of death in the next few months and of failure to regain independence in the survivors. These adverse factors appeared to correlate with infarction extending beyond the middle cerebral artery territory, severe brain swelling and recent occlusion of the internal carotid artery.