LONG-TERM PROGNOSIS OF SYMPTOMATIC LACUNAR INFARCTS - A HOSPITAL-BASED STUDY

Background and Purpose This study concerns the long-term prognosis of lacunar infarcts. Methods We report the analysis of our hospital-based series of 178 patients consecutively admitted for a lacunar syndrome due to a lacunar infarct diagnosed with computed tomography and magnetic resonance imaging. Demographic data, medical history, vascular risk factors, and imaging data were recorded for each patient. The follow-up was 35+/-22 months. Results The lacunar syndrome was pure motor hemiparesis in 69 patients (39%), ataxic hemiparesis in 45 patients (25.4%), pure sensory stroke in 15 patients (8.5%), sensorimotor stroke in 14 patients (7.9%), and miscellaneous syndrome in 34 patients (19.2%). The 4-year survival rate was 80+/-4% and the 4-year survival rate without recurrent stroke was 85+/-3.5%. Using Cox proportional-hazards analysis, the predictors of death were age (P<.02), diabetes mellitus (P<.05), and cigarette smoking (P<.05). We did not find any predictors of recurrence. After 1 year, 74% of the patients had mild or no disability. Using logistic regression analysis, the predictive factors of disability were age more than 70 years (P<.01), diabetes (P<.01), history of stroke or transient ischemic attack (P<.05), and type of lacunar syndrome (P<.01). Imaging data, number of lacunes, and presence of leukoaraiosis were not predictors of outcome. Conclusions Our study suggests that with a high survival rate, a low recurrence rate, and a relatively good functional recovery, lacunar infarcts have a relatively favorable prognosis.