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Outcome in lacunar stroke: A cohort study

V Mantero1, C Scaccabarozzi1, E Botto1

  • 1Neurology - Stroke Unit, "A. Manzoni" Hospital, ASST Lecco, Lecco, Italy.

Acta Neurologica Scandinavica
|May 18, 2018
PubMed

Insights

Prompt recognition and treatment of infections, along with managing inflammatory markers, significantly impact functional outcomes for patients with lacunar stroke. Early intervention is key to reducing clinical deterioration and improving recovery.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Infectious Diseases

Background:

  • Lacunar strokes are a significant cause of neurological disability.
  • Identifying prognostic factors is crucial for timely intervention and improved patient outcomes.
  • Early clinical deterioration can exacerbate the impact of lacunar stroke.

Purpose of the Study:

  • To evaluate the outcomes of lacunar stroke patients at discharge and 6 months post-stroke.
  • To identify correlations between cardiovascular risk factors, biochemical parameters, and stroke outcomes.
  • To pinpoint prognostic factors for targeted interventions aimed at reducing clinical deterioration.

Main Methods:

  • Prospective cohort study of 150 lacunar stroke patients.
  • Clinical 6-month follow-up for 98.7% of participants.
  • Classification of infarcts by size, shape, and location.

Main Results:

  • Predictors of high NIHSS score at discharge included admission NIHSS, leukocytosis, in-hospital infections, and lacunar size.
  • Predictors of poor 6-month outcome included admission NIHSS, leukocytosis, elevated CRP, and pre-admission Rankin score.
  • Infections, while not causative, significantly influenced functional outcomes.

Conclusions:

  • Prompt recognition and treatment of infections are critical for improving functional outcomes in lacunar stroke.
  • Controlling inflammatory markers and fever are important in managing lacunar stroke patients.
  • Early interventions targeting identified prognostic factors can reduce the incidence and impact of clinical deterioration.
Abstract

Keywords:
C-reactive proteininfectionsinflammatory markerslacunar strokeoutcome

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