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Prognosis of patients with middle cerebral artery occlusion
Abstract:
The long-term prognosis of 78 stroke patients with occlusion of the middle cerebral artery (MCA) or its branches is described. The mean age of the patients was 44 years. The mortality rate in the acute phase was 5%. The acute and total mortality rates of men were higher than those of women (p less than 0.05). Life-table analysis gave 94% probability for one year's survival, 84% for three years' survival, and 78% for five years' survival. Subsequent strokes were twice as common as cardiovascular events as the cause of death. Seventy-two percent of the survivors became fully independent in activities of daily living (ADL) , 27% required assistance, 1% was totally disabled, and 43% returned to work. Left-sided occlusion was overrepresented in those who died (p less than 0.00(1) and those who returned to work (p less than 0.05), and right-sided occlusion was overrepresented in those who required assistance in ADL (p less than 0.05).
Insights
This study followed 78 stroke patients with middle cerebral artery (MCA) occlusion. Most survivors regained independence, but subsequent strokes were a significant cause of death.
Area of Science:
- Neurology
- Vascular Neurology
- Stroke Medicine
Background:
- Middle cerebral artery (MCA) occlusions represent a significant cause of stroke.
- Understanding the long-term prognosis is crucial for patient management and rehabilitation.
Purpose of the Study:
- To describe the long-term prognosis of patients with MCA occlusion.
- To analyze mortality rates, survival probabilities, and functional outcomes.
- To investigate the influence of occlusion side on outcomes.
Main Methods:
- Retrospective analysis of 78 stroke patients with MCA or its branch occlusions.
- Life-table analysis for survival probability.
- Assessment of activities of daily living (ADL) and return to work.
Main Results:
- The mean age was 44 years, with a 5% acute mortality rate.
- Five-year survival probability was 78%; subsequent strokes were the leading cause of death.
- 72% of survivors achieved independence in ADL, 43% returned to work.
- Left MCA occlusion correlated with higher mortality and return to work; right MCA occlusion with ADL assistance needs.
Conclusions:
- Long-term survival after MCA occlusion is substantial, but recurrent strokes pose a significant risk.
- Functional recovery varies, with a notable proportion regaining independence and returning to work.
- The side of MCA occlusion influences mortality and functional outcomes, suggesting potential lateralized effects.