Ischemic stroke: relation of age, lesion location, and initial neurologic deficit to functional outcome

Abstract

Objective: Establish the relation between age, gender, initial neurologic deficit, stroke location, prior stroke, hemisphere of stroke, and functional outcome in ischemic stroke.

Design: Single group, multivariate, repeated measures design with 327 persons having ischemic stroke recruited from 20 participating centers.

Setting: Twenty European stroke centers.

Patients: Consecutive admissions of men and women between the ages of 40 and 85 yrs with a hemispheric stroke caused by middle cerebral artery ischemia and a Unified Neurological Stroke Scale score of 5 to 24.

Interventions: Inpatients enrolled in the trial received traditional rehabilitation therapies including physical therapy, occupational therapy, and speech therapy when appropriate.

Main outcome measures: Barthel Index computed at 7 to 10 days and 3 months poststroke.

Results: Positive functional outcomes were significantly related to the absence of prior strokes, a younger age, a less severe initial neurologic deficit, stroke involving cortical structures, and dominant (left hemisphere) lesions.

Conclusions: Despite some inconsistencies in existing literature, standardized prospective examination of outcome after stroke clearly demonstrated the effect of age, initial severity of stroke, and lesion location as predictors of functional outcome.