Long-term prognosis of patients with large subcortical infarctions

Eur Neurol. 2009;62(5):304-10. doi: 10.1159/000235943. Epub 2009 Sep 3.


Aim: We assessed the long-term prognosis of patients with large subcortical infarctions (LSCI).

Methods: We defined LSCI as lesions > or =15 mm confined to deep penetrating arteries without a cardioembolic or atherothrombotic source. Patients with acute ischemic strokes were consecutively registered and followed for 751 +/- 441 days. The clinical characteristics and long-term prognoses of patients with LSCI were compared to those of patients with lacunar (LACI), atherothrombotic (ATI) and cardioembolic infarctions (CEI).

Results: At discharge from the hospital, the proportion of good outcomes (modified Rankin Scale < or =2) for patients with LSCI (52.1%) was similar to that for ATIs (47.2%), but worse than that for LACIs (73.2%). After a 3-year follow-up period, the mortality rates from LSCI, LACIs, ATIs and CEIs were 8.4, 8.2, 22.3 and 41.1%, respectively; the recurrence rates were 9.3, 14.1, 16.6 and 23.8%, respectively.

Conclusions: The short-term prognosis of functional outcomes for LSCI was worse than that for LACIs, but similar to acute-phase ATI outcomes. The long-term prognosis after a LSCI is good, and recurrence tends to be lower than for LACIs.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cerebral Infarction / diagnosis*
  • Cerebral Infarction / mortality
  • Cerebral Infarction / pathology
  • Disability Evaluation
  • Disease Progression*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Selection
  • Prognosis
  • Recurrence
  • Severity of Illness Index
  • Survival Analysis
  • Treatment Outcome