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Functional outcome in patients with lacunar infarction
M Samuelsson1, B Söderfeldt, G B Olsson
1Department of Neurology, Orebro Medical Center Hospital, Sweden.
Stroke
|May 1, 1996
Summary
Lacunar infarction prognosis is generally favorable, but motor impairment and white matter disease predict poor outcomes. Recurrent strokes worsen disability, though not independently significant. Activities of Daily Living (ADL) measures may underestimate stroke impact.
Area of Science:
- Neurology
- Neuroscience
- Stroke Medicine
Background:
- Prognosis and predictive factors for functional outcome after lacunar infarction are not well understood.
- Limited long-term follow-up data exists for lacunar infarction patients.
Purpose of the Study:
- To analyze the prognosis and predictive factors for functional outcome after lacunar infarction.
- To provide a longer follow-up than previous studies.
Main Methods:
- 81 patients with first-ever lacunar infarction were assessed for impairment, disability (Activities of Daily Living [ADL]), and handicap.
- Patients were followed for 3 years, with functional outcomes measured using validated scales.
- Logistic multivariate regression identified predictors of functional dependence or death.
Main Results:
- 6% mortality and 21% recurrent strokes occurred during follow-up.
- Moderate/severe hemiparesis at 1 month and white matter hyperintensities on MRI were strong predictors of poor outcome.
- Initial recovery was fast for most, but disability in personal ADL increased from 12% at 1 year to 24% at 3 years, mainly due to recurrent strokes.
Conclusions:
- Functional outcome for physical independence is generally favorable after lacunar infarction.
- Motor impairment and white matter disease are key predictors of poor functional outcome.
- While recurrent strokes increase disability, they were not independent predictors; ADL measures alone may underestimate long-term consequences.