Authors: S Micheli G Agnelli F Palmerini V Caso M Venti A Alberti S Biagini M Paciaroni
Publish Date: 2008/02/19
Volume: 255, Issue: 5, Pages: 637-642
Abstract
Smallvessel disease is the most frequent cause of lacunar stroke The aims of this study were to evaluate 1 alternative causes of lacunar stroke other than smallvessel disease 2 functional outcome of lacunar strokes due to small vessel disease compared to lacunar strokes due to alternative causesConsecutive patients with firstever ischemic lacunar stroke were prospectively followedup for at least 3 months At discharge patients were divided into 2 groups lacunar stroke due to small vessel disease LSVD and lacunar stroke due to possible other etiologies Lnon SVD e g cardioembolism atherosclerosis or other causes Main outcome measures were the combined end point of death or disability mRS ≥ 3 and recurrent stroke at the end of followup535 patients with acute stroke were seen during the study period Out of these 196 patients 126 males with a mean age of 716 years SD = 10 had lacunar stroke LSVD was seen in 142 patients 724 and LnonSVD in 54 patients 276 After 164 months 12 patients had died 62 annual mortality rate 44 63 were disabled 325 and 27 had stroke recurrence 139 annual recurrence rate 99 Fortynine patients with LSVD 347 and 26 with LnonSVD 49 had died or become disabled Sixteen patients with LSVD 113 and 11 with LnonSVD 204 had stroke recurrence On multivariate analysis LnonSVD OR = 287 95 CI 108–765 p = 0034 and age OR = 107 95 CI 102–112 p = 001 were associated to more severe outcome LnonSVD was independently associated with recurrence OR = 503 95 CI 154–1644 p = 0006Twentyseven percent of patients with lacunar stroke have causes other than small vessel disease These patients have a severe outcome in terms of recurrencemortality or disability These findings support the need for a comprehensive diagnostic workup for patients with lacunar stroke
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