There are only a few reports on long-term prognosis and functional out
come after lacunar infarction, and little is known about the evolution
of MRI abnormalities with time in this subtype of stroke. To address
these issues, we performed a 1-year clinical and MRI follow-up study i
n 81 patients with presumed lacunar infarction. AT 1 year after stroke
onset 1 patient had died, whereas 5 patients (6.2%) had had recurrent
strokes. Based on the Oxford Handicap Scale, 63 (79%) of the survivin
g patients were functionally independent at the time of follow-up. MRI
at 1 year revealed new, clinically silent infarcts in 8 patients (10%
), and wallerian degeneration of the pyramidal tract in 8 (24%) of the
34 patients with posterior capsular or putamenal infarcts on initial
MRI. Our data suggest that new, clinically silent infarcts may be at l
east as common as recurrent strokes in patients with lacunar infarctio
ns.