Large subcortical infarcts - Clinical features, risk factors, and long-term prognosis compared with cortical and small deep infarcts

Background and Purpose-In this study we compared risk factors, clinical features, and stroke recurrence in a large series of patients with large subcortical, cortical, or small deep infarcts. Methods-Patients with a transient or minor ischemic attack (modified Rankin Scale grade of <= 3) who had a single relevant supratentorial infarct of presumed noticardioembolic origin on CT were classified as suffering from a large subcortical (n = 120), small deep (n = 324), or cortical (n = 211) infarct. Mean follow-up was 8 years. Rates of recurrent stroke were compared with Cox regression. Results-The clinical deficits caused by large subcortical infarcts resembled either those of a cortical or those of a small deep infarct. Risk factor profiles were similar in the 3 groups. The rate of recurrent stroke in patients with a large subcortical infarct (25/120; 21%) did not differ from that of patients with a cortical infarct (46/211; 22%) or with a small deep infarct (60/324; 19%). After adjustment for age, sex, and vascular risk factors, hazard ratios for recurrent stroke of large subcortical and cortical infarcts were 1.05 (95% CI, 0.65 to 1.70) and 1.17 (95% CI, 0.79 to 1.73), respectively, compared with small deep infarcts. Conclusions-Clinical features, risk factor profiles, and stroke recurrence rate in patients with a large subcortical infarct only differ slightly from those in patients with small deep or cortical infarcts.