PURE MOTOR STROKE FROM PRESUMED LACUNAR INFARCT - INCIDENCE, RISK-FACTORS AND INITIAL COURSE

We determined the epidemiologic and clinical features in 180 patients with pure motor stroke (PMS) and presumed lacunar infarct (presumed lacunar PMS) collected from a population-based stroke registry during a 4-year period (1983-1986). Presumed lacunar PMS constituted 87.4% of all lacunar infarcts and 12.6% of all strokes. The age-adjusted incidence of presumed lacunar PMS was 26.6/100,000/year. Hypertension was present in 52.2 and diabetes in 15.6% of the patients. Compared to the whole stroke group, hypertension was more prevalent in presumed lacunar PMS, whereas atrial fibrillation, other cardioembolic sources, and previous myocardial infarction were less common; no difference in the prevalence of diabetes was observed. In presumed lacunar PMS, 66.0% of the patients < 75 years of age had hypertension versus only 36.1% in the patients > 75 years (odds ratio = 3.42, 95% confidence interval = 1.85-6.32). 16.1% of the patients had prior TIAs, and 38.3% initially progressed, mainly within the first 24 h after onset. At 3 weeks, 63.1% had no or minor residua, 26.3% moderate residua, and 11.2% severe hemiparesis. The study shows that the risk factor profile in presumed lacunar PMS is related to age. The features of the initial course indicate the need to separate this type of cerebral infarct from other stroke subtypes in treatment trials.