Recovery of motor functions following hemiparetic stroke: A clinical and magnetic resonance-morphometric study

Predictors for the degree of clinical recovery after stroke are still poorl y defined. in this study we tried to assess the predictive value of clinica l data and of lesion size for motor recovery after ischemic stroke. In 52 h emiparetic patients we monitored the course of clinical recovery by a dedic ated score of sensorimotor hand function after their first stroke. The cour se of the lesion size was measured in proton density magnetic resonance ima ges. Three groups of patients were identified. Patients with moderate initi al motor deficit recovered almost completely within 9 days (17/17, group 1) . From the patients with severe initial motor deficit, about equal numbers recovered (16/35, group 2) or remained severely impaired during the entire observation period of more than 6 months (19/35, group 3), There was no cor relation between changes of lesion size and motor deficit. Logistic regress ion of probability of good clinical outcome on initial lesion size, initial motor score and subcortical versus cortical location of lesion showed that only the initial motor score was predictive (p = 0.006), A relative improv ement of the initial motor score of about 20% in the first 4 weeks after st roke appeared to be a relevant cut point for good outcome. The data indicat e that patients with mild initial motor deficits recover well, whereas seve rely affected patients may differ in outcome. Since lesion size was not cor related with outcome the amount of spared residual function appeared as maj or determinant for the capacity for motor recovery. Copyright (C) 2001 S. K arger AG, Basel.