THE IMPORTANCE OF BRAIN INFARCT SIZE AND LOCATION IN PREDICTING OUTCOME AFTER STROKE

Fifty-six consecutive elderly (greater than or equal to 65 years) pati ents, admitted for acute stroke to a geriatric department were include d in the study and underwent CT scanning. Functional status was graded according to the modified Rankin scale. Three patients had primary in tra-cerebral haemorrhage, 22 deep hemispheric infarct, 17 had anterior circulation cortical infarcts, five had posterior circulation infarct s and in nine the CT scan was normal. Stroke risk factors were equally distributed among the different CT scan groups, and all three larger groups had similar rates of non-neurological major complications inclu ding death (41%). However, independence in ADL (Rankin 0-2) was observ ed in 72% of deep infarct survivors, but only 15% of the cortical infa rct group (p = 0.0018). For the normal scan group, functional recovery was intermediate. In the cortical infarct group, patients with an inf arct of greater than or equal to 50 mm mean diameter (five cases) show ed worse functional recovery than did eight patients with small infarc ts. The mean difference between pre- and post-stroke Rankin score (DR) was 3.4 for the larger infarct patients and 1.9 for the smaller infar ct group (p = 0.027). Pearson correlation revealed a direct relationsh ip between the infarction size and DR (p = 0.039). Such a relationship was not observed for the deep hemispheric group.