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Two hundred nineteen patients(42%)presented a lacunar syndrome and 298 (58%)a nonlacunar syndrome,while 170(33%)had lacunar infarcts and 347(67%) nonlacunar infarcts.Lacunar infarct patients were more frequently associated with hypertension and a previous transient ischemic attack and less frequently with atrial fibrillation when compared with their nonlacunar infarct counterparts,whereas no differences were apparent between lacunar syndrome and nonlacunar syndrome patients.Logistic regression analysis showed that hypertension and a previous transient ischemic attack on the one hand and atrial fibrillation on the other were strongly correlated with the diagnosis of lacunar infarct and nonlacunar infarct,respectively,while no risk factor was correlated with the diagnosis of lacunar syndrome.Twenty-two percent of lacunar infarct patients and 68%of nonlacunar infarct subjects had a poor outcome(death plus disability of survivors)as opposed to 40%of lacunar syndrome and 63% of nonlacunar syndrome patients.Logistic regression selected age,severity of neurological deficit at entry,cardiopathies,diabetes,and lacunar infarct,but not lacunar syndrome,as predictors of outcome.The inaccurate clinical diagnosis of lacunar infarct made in the first 12 hours of stroke might lead to no distinction being made between stroke subgroups with potentially different pathogenetic mechanisms and prognostic estimates, thus negatively influencing the planning of patient management. |
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CAT scan
CAT scan,abnormal
cerebrovascular accident
cerebrovascular accident,clinical diagnosis
cerebrovascular accident,misdiagnosis
lacunar infarction
lacunar infarction,differential diagnosis of
lacunar syndrome
misdiagnosis
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