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Outcome in lacunar stroke: A cohort study
Author(s) -
Mantero V.,
Scaccabarozzi C.,
Botto E.,
Giussani G.,
Aliprandi A.,
Lunghi A.,
Ciusani E.,
Brenna G.,
Salmaggi A.
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12961
Subject(s) - cohort , stroke (engine) , lacunar stroke , medicine , cohort study , physical medicine and rehabilitation , physical therapy , psychology , ischemic stroke , psychiatry , mechanical engineering , ischemia , engineering
Objectives We evaluated a prospective cohort of 150 patients under observation in our centre for lacunar strokes. The purpose of this study was to evaluate the outcome at time of discharge and 6 months after lacunar stroke, as well as the correlation with cardiovascular risk factors and selected biochemical parameters already evaluated on admission. Focus was to identify possible prognostic factors, which might be targeted through appropriate intervention concentrating on reduction in the incidence and impact of early clinical deterioration. Methods 150 patients with a lacunar stroke were included in the present study. A clinical 6‐month follow‐up was available for 98.7% of the patients. Infarcts were classified by size, shape and location. Results The most important predictors of high NIHSS score at time of discharge resulted NIHSS on admission ( P < .001), leukocytosis ( P = .013), in‐hospital infections ( P = .016) and size of lacunae ( P = .005). Similarly, the most important predictors of poor outcome 6 months later were NIHSS on admission ( P = .01), leukocytosis ( P = .014), elevated CRP ( P = .019), in addition to pre‐admission Rankin ( P < .001). Conclusion Although infections are not causatively related to lacunar strokes, their prompt recognition and early treatment, control of inflammatory markers and fever are most important in influencing functional outcome in lacunar stroke.