FUNCTIONAL OUTCOME FOR PATIENTS WITH HEMIPARESIS, HEMIHYPESTHESIA, AND HEMIANOPIA - DOES LESION LOCATION MATTER

Background and Purpose Patients with hemiparesis, hemisensory loss, an d hemianopsia (''HHH'' deficits) due to stroke may have large cortical lesions caused by middle cerebral trunk vessel occlusion or smaller s ubcortical lesions due to lenticulostriate involvement. We studied the usefulness of lesion location in predicting functional recovery withi n this syndrome. Methods We reviewed our records and found 41 patients who had a single ischemic hemispheric stroke, HHH deficits, and an av ailable CT scan performed more than 24 hours after the onset of sympto ms. CT scans were read independently and blindly by the authors. Lesio ns were initially categorized by arterial distribution on the basis of CT templates published by Kinkel. The numerous combinations of arteri al branch vessel occlusions observed did not allow for statistical ana lyses because of the small number of subjects within each subgroup. Le sions were therefore classified as cortical (C), subcortical (S), or m ixed (M). Results There were no significant differences among the thre e anatomic groups for age, sex, interval after stroke, Mini-Mental Sta tus Examination score, or admission Barthel Index score. Functional ou tcome measures did not differ significantly for the three groups: mean +/-SD discharge Barthel score (C, 64+/-31; S, 47+/-20; M, 57+/-21), le ngth of stay ([days] C, 64+/-25; S, 77+/-24; M, 73+/-28), and frequenc y of nursing home placement (C, 4/8; S, 3/6; M, 2/16). Conclusions For patients with HHH deficits, the anatomic location of the lesion (C ve rsus S versus M) does not affect functional outcome.