Factors influencing the prognosis of cerebral thrombosis and infarction due to atherosclerosis

Abstract

A prospective study was made of the survival of 100 patients with cerebral infarction or ischemia due to atherosclerosis. During the initial hospitalization, 10 patients died as a result of the acute infarction or its complications. In the ensuing 2 years, 23 additional patients died—usually from cerebral or systemic vascular disease. Increased mortality was found in patients having a history of previous cerebral infarction, signs of diffuse or bilateral brain stem lesions, or severe hypertension. Approximately one-fourth of the survivors returned to work. The serious prognosis of cerebral infarction is demonstrated by this study, and attention is directed to the high rate of recurrence (20 per cent) of cerebral infarction among the immediate survivors. Although treatment of the generalized atherosclerosis and its thromboembolic complications may be successful in decreasing the over-all mortality, a more definitive therapeutic approach to the cerebral vasculature by surgery or other means appears necessary to reduce the high mortality and morbidity caused by recurrent strokes.