Prevalence and Clinical Characteristics of Lacunar Stroke: A Hospital-Based Study.

Mohammed A Aldriweesh,Sultan A Alsaif,Abrar A Alajlani,Mohammed A Alskaini,Bayan A Al Bdah,Waleed A Alluhidan,Ali M Al Khathaami,Faisal M Almutairi,Muath A Alhasson,Naser Alotaibi

doi:10.3390/brainsci11111466

Abstract

Lacunar stroke (LS) is responsible for one-quarter of the overall number of ischemic strokes with long-term complications and carries health and economic issues for patients and health care systems. Therefore, we aimed to investigate lacunar versus non-lacunar strokes in a tertiary academic center. From February 2016 to July 2019, all patients admitted to the stroke unit were retrospectively reviewed. We included LS patients and compared them to other TOAST subtypes. Hemorrhagic stroke and conditions mimicking stroke were excluded. Regression analysis was done to determine LS predictors and outcomes. A 35.5% rate of LS among 989 ischemic stroke patients was found. Most patients (71.9%) were males. Lower National Institutes of Health Stroke Scale (NIHSS) scores at admission and negative history for cardiac diseases were predictors for LS in our population. At discharge, LS patients had low NIHSS scores and shorter hospitalization periods compared to non-LS patients. In conclusion, LS was prevalent among ischemic stroke patients in our cohort. Future studies are highly needed with long follow-up intervals to identify the stroke recurrence, complications, and outcomes.

Highlights

Stroke is a leading cause of morbidity and mortality worldwide [1]
74.4% (N = 263) of patients with history of HTN followed by T2DM (70.5%; N = 248) were involved
ischemic heart disease (IHD) was found in 7.4% and dyslipidemia in 34.9% among Lacunar stroke (LS) patients

Summary

Introduction

Stroke is a leading cause of morbidity and mortality worldwide [1]. The absolute number of first-time ischemic strokes is increasing compared with the number of hemorrhagic strokes [2]. Some studies have applied the risk factor-free ischemic stroke subtype definitions and found no differences that could be attributed to HTN and T2DM with respect to either LS or non-LS [12]. A study that followed ischemic stroke patients, precisely LS, for 25 years found that dementia increased twice compared with the rest of the population [17]. The outcomes of LS differ significantly as some patients may have satisfactory recoveries, and others have a disability such as dependency, depression, and cognitive impairment [18] Some factors such as age, male gender, second stroke, National Institutes of Health Stroke Scale (NIHSS) score upon admission, pre-stroke modified Rankin Scale (mRS), and T2DM, might predict the outcomes [17,19,20]. In the Kingdom, to our knowledge, no previous study has investigated LS patients compared to other ischemic stroke subtypes based on TOAST classification

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