Lacunar Infarcts: A 1-Year Clinical and MRI Follow-Up Study

Abstract

There are only a few reports on long-term prognosis and functional outcome after lacunar infarction, and little is known about the evolution of MRI abnormalities with time in this subtype of stroke. To address these issues, we performed a 1-year clinical and MRI follow-up study in 81 patients with presumed lacunar infarction. AT 1 year after stroke onset 1 patient had died, whereas 5 patients (6.2%) had had recurrent strokes. Based on the Oxford Handicap Scale, 63 (79%) of the surviving patients were functionally independent at the time of follow-up. MRI at 1 year revealed new, clinically silent infarcts in 8 patients (10%), and wallerian degeneration of the pyramidal tract in 8 (24%) of the 34 patients with posterior capsular or putamenal infarcts on initial MRI. Our data suggest that new, clinically silent infarcts may be at least as common as recurrent strokes in patients with lacunar infarctions.