Functional outcome for patients with hemiparesis, hemihypesthesia, and hemianopsia. Does lesion location matter?
OBJECTIVE
Patients with hemiparesis, hemisensory loss, and hemianopsia ("HHH" deficits) due to stroke may have large cortical lesions caused by middle cerebral trunk vessel occlusion or smaller subcortical lesions due to lenticulostriate involvement. We studied the usefulness of lesion location in predicting functional recovery within this syndrome.


METHODS
We reviewed our records and found 41 patients who had a single ischemic hemispheric stroke, HHH deficits, and an available CT scan performed more than 24 hours after the onset of symptoms. CT scans were read independently and blindly by the authors. Lesions were initially categorized by arterial distribution on the basis of CT templates published by Kinkel. The numerous combinations of arterial branch vessel occlusions observed did not allow for statistical analyses because of the small number of subjects within each subgroup. Lesions were therefore classified as cortical (C), subcortical (S), or mixed (M).


RESULTS
There were no significant differences among the three anatomic groups for age, sex, interval after stroke, Mini-Mental Status Examination score, or admission Barthel Index score. Functional outcome measures did not differ significantly for the three groups: mean +/- SD discharge Barthel score (C, 64 +/- 31; S, 47 +/- 20; M, 57 +/- 21), length of stay ([days] C, 64 +/- 25; S, 77 +/- 24; M, 73 +/- 28), and frequency 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 versus S versus M) does not affect functional outcome.
D000368:Aged; D001921:Brain / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000473:pathology*; D005260:Female; D006423:Hemianopsia / Q000209:etiology / Q000473:pathology*; D006429:Hemiplegia / Q000209:etiology / Q000473:pathology*; D006801:Humans; D006987:Hypesthesia / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013577:Syndrome