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Long-term prognosis of patients with large subcortical infarctions

Yutaka Suto1, Hiroyuki Nakayasu, Masanobu Maeda

  • 1Department of Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan. sutou@med.tottori-u.ac.jp

European Neurology
|September 5, 2009
PubMed

Insights

Large subcortical infarctions (LSCI) have a good long-term prognosis with lower recurrence rates compared to lacunar infarctions. Short-term outcomes for LSCI are similar to atherothrombotic infarctions.

Area of Science:

  • Neurology
  • Cardiovascular Research
  • Stroke Medicine

Background:

  • Large subcortical infarctions (LSCI) are a distinct subtype of ischemic stroke.
  • Understanding the prognosis of LSCI is crucial for patient management and outcome prediction.

Purpose of the Study:

  • To assess the long-term prognosis of patients diagnosed with large subcortical infarctions (LSCI).
  • To compare the clinical characteristics and prognoses of LSCI patients with other stroke subtypes, including lacunar (LACI), atherothrombotic (ATI), and cardioembolic infarctions (CEI).

Main Methods:

  • LSCI was defined as lesions greater than or equal to 15 mm affecting deep penetrating arteries without identified cardioembolic or atherothrombotic sources.
  • Patients with acute ischemic stroke were consecutively registered and followed for an average of 751 days.
  • Outcomes were compared between LSCI, LACI, ATI, and CEI groups.

Main Results:

  • Short-term functional outcomes (modified Rankin Scale < or =2) at hospital discharge were similar for LSCI (52.1%) and ATI (47.2%), but worse than for LACI (73.2%).
  • After 3 years, mortality rates were LSCI (8.4%), LACI (8.2%), ATI (22.3%), and CEI (41.1%).
  • Recurrence rates at 3 years were LSCI (9.3%), LACI (14.1%), ATI (16.6%), and CEI (23.8%).

Conclusions:

  • The short-term prognosis for functional outcomes in LSCI is less favorable than in LACI but comparable to ATI.
  • The long-term prognosis following a large subcortical infarction is generally good.
  • Recurrence rates for LSCI tend to be lower than for lacunar infarctions.
Abstract

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