Clinical study of 227 patients with lacunar infarcts.

Abstract

We describe an analysis of 227 patients with lacunar infarcts; 177 were inpatients and the remaining 50 were outpatients. The group comprised 11% of all inpatients with cerebrovascular pathology and 16% of all consecutive inpatients with brain infarcts studied at the Department of Neurology of the Hospital de la Santa Creu i Sant Pau. The main risk factors identified in these patients were arterial hypertension in 164 (72%), diabetes mellitus in 64 (28%), and heart disease in 58 (26%). The most common clinical syndromes were pure motor hemiparesis in 125 (55%), pure hemisensory stroke in 42 (18%), the sensorimotor deficit syndrome in 34 (15%), ataxic hemiparesis in seven (3%), and the dysarthria-clumsy hand syndrome in four (2%); atypical syndromes were observed in 15 patients (7%). Lacunes were demonstrated by computed tomography in 100 patients (44%) and by magnetic resonance imaging in 35 (78%) of the 45 patients in which it was applied. Magnetic resonance imaging was significantly better (p< 0.001) than computed tomography for imaging lacunes, especially those located in either the pons (p<0.005) or the internal capsule (/xO.001). After the acute phase, mild or no neurologic disability was detected in 178 patients (78.4%), moderate disability persisted in 48 patients (

Leukoaraiosis in relation to prognosis for patients with lacunar infarction.

“…In another report, moderate to severe disabilities persisted in 20% of the lacunar infarct patients after the acute phase. 34 In the present study, one third of the LA+ patients were dependent in ADL 1 month after stroke onset, which was three times the number of the dependent patients among L A -patients. LA itself is often associated with some neurological deficits.…”

Epidemiological characteristics of lacunar infarcts in a population.

“…Magnetic resonance imaging provides better resolution than CT, but the best resolution 33 - 34 is obtained a few days after the infarct is clinically evident. …”

Worsening in Ischemic Stroke Patients: Is it Time for a New Strategy?

“…In a Spanish study of 225 lacunar infarct patients, the deficit accrued within hours in 50.5% and within days in 16%. 6 In a study from Sweden, among 61 patients with lacunar strokes, all pure motor hemiplegia, 22 (36%) worsened after the first hour of symptoms and 18/22 (82%) progressions occurred during the first 24 hours. 7 In the study by Steinke and Ley, 24% of patients had a worsening of motor deficits after hospitalization, and the predominant subtype of stroke was lacunar infarction.…”