BACKGROUND AND PURPOSE: Little is known about the prognosis and the predictive factors for functional outcome after lacunar infarction. Our aim was to analyze this issue in more detail and with a longer follow-up than in previous reports. METHODS: Functional outcome was assessed in 81 consecutive patients with a first-ever stroke and clinical and MRI findings compatible with lacunar infarction. We measured impairment (motor, sensory, and cognitive function), disability (Katz's Index of Activities of Daily Living [ADL] and four instrumental activities), and handicap (Oxford Handicap Scale). The patients were followed up for 3 years. RESULTS: During follow-up, 6% of the patients died and 21% had recurrent strokes, mostly new lacunar infarcts. A fast initial recovery was found in most patients. At 1 year, 12% were dependent in personal ADL, which after 3 years had increased to 24%, mostly as a result of the effects of recurrent strokes. In a logistic multivariate regression model, moderate or severe hemiparesis 1 month after stroke onset was the strongest predictor of physical dependence or death at 3 years (P < .001), followed by white matter hyperintensities on MRI (P < .01). Age, vascular risk factors, and recurrent stroke were not statistically significant independent predictors of functional outcome. CONCLUSIONS: Functional outcome regarding physical independence was favorable in most patients. Motor impairment and white matter disease were the strongest predictors of a poor functional outcome. Recurrent stroke increased disability and handicap but was not a statistically significant independent risk factor. Measurements of personal ADL alone were insensitive in detecting the consequences of stroke in many patients with preserved self-care ability, who still experienced disability and handicap.
BACKGROUND AND PURPOSE: Little is known about the prognosis and the predictive factors for functional outcome after lacunar infarction. Our aim was to analyze this issue in more detail and with a longer follow-up than in previous reports. METHODS: Functional outcome was assessed in 81 consecutive patients with a first-ever stroke and clinical and MRI findings compatible with lacunar infarction. We measured impairment (motor, sensory, and cognitive function), disability (Katz's Index of Activities of Daily Living [ADL] and four instrumental activities), and handicap (Oxford Handicap Scale). The patients were followed up for 3 years. RESULTS: During follow-up, 6% of the patients died and 21% had recurrent strokes, mostly new lacunar infarcts. A fast initial recovery was found in most patients. At 1 year, 12% were dependent in personal ADL, which after 3 years had increased to 24%, mostly as a result of the effects of recurrent strokes. In a logistic multivariate regression model, moderate or severe hemiparesis 1 month after stroke onset was the strongest predictor of physical dependence or death at 3 years (P < .001), followed by white matter hyperintensities on MRI (P < .01). Age, vascular risk factors, and recurrent stroke were not statistically significant independent predictors of functional outcome. CONCLUSIONS: Functional outcome regarding physical independence was favorable in most patients. Motor impairment and white matter disease were the strongest predictors of a poor functional outcome. Recurrent stroke increased disability and handicap but was not a statistically significant independent risk factor. Measurements of personal ADL alone were insensitive in detecting the consequences of stroke in many patients with preserved self-care ability, who still experienced disability and handicap.
Authors: Oscar R Benavente; Carole L White; Lesly Pearce; Pablo Pergola; Ana Roldan; Marie-France Benavente; Christopher Coffey; Leslie A McClure; Jeff M Szychowski; Robin Conwit; Patricia A Heberling; George Howard; Carlos Bazan; Gabriela Vidal-Pergola; Robert Talbert; Robert G Hart Journal: Int J Stroke Date: 2011-01-26 Impact factor: 5.266
Authors: Shuhan Zhu; Leslie A McClure; Helena Lau; Jose R Romero; Carole L White; Viken Babikian; Thanh Nguyen; Oscar R Benavente; Carlos S Kase; Aleksandra Pikula Journal: Neurology Date: 2015-09-15 Impact factor: 9.910
Authors: Carole L White; Leslie A McClure; Patricia M Wallace; Janet Braimah; Alice Liskay; Ana Roldan; Oscar R Benavente Journal: Cerebrovasc Dis Date: 2011-09-15 Impact factor: 2.762
Authors: Martin Griebe; Elisabeth Fischer; Micha Kablau; Philipp Eisele; Marc E Wolf; Anastasios Chatzikonstantinou; Achim Gass; Michael G Hennerici; Kristina Szabo Journal: J Neurol Date: 2013-12-24 Impact factor: 4.849
Authors: Luduan Zhang; Andrew J Butler; Chang-Kai Sun; Vinod Sahgal; George F Wittenberg; Guang H Yue Journal: Brain Res Date: 2008-06-11 Impact factor: 3.252
Authors: Brett Kissela; Christopher J Lindsell; Dawn Kleindorfer; Kathleen Alwell; Charles J Moomaw; Daniel Woo; Matthew L Flaherty; Ellen Air; Joseph Broderick; Joel Tsevat Journal: Stroke Date: 2008-12-24 Impact factor: 7.914