Recurrent lacunar infarction following a previous lacunar stroke: a clinical study of 122 patients.
OBJECTIVE
To determine clinical variables related to recurrent lacunar infarction following a previous lacunar stroke.


METHODS
A total of 122 out of 733 consecutive patients with lacunar infarction collected from a hospital based registry between 1986 and 2004 were readmitted because of a recurrent lacunar infarction. In a subset of 59 patients, cognition was assessed using the Mini-Mental State Examination (MMSE). Predictors of lacunar infarction recurrence were assessed by logistic regression analysis.


RESULTS
First lacunar infarction recurrence occurred in 101 patients (83%) and multiple recurrences in 21. The mean time between first ever lacunar infarction and recurrent lacunes was 58.3 months (range 2-240). In the subset of 59 patients in whom cognition was studied, cognitive impairment, defined as an MMSE score <24, was detected in 16% (8/49) of patients with first lacunar infarction recurrence and in 40% (4/10) of those with multiple lacunar infarction recurrences. In the multivariate analysis, hypertension (odds ratio 2.01, 95% CI 1.23 to 3.30) and diabetes (odds ratio 1.62, 95% CI 1.07 to 2.46) were significant predictors of lacunar stroke recurrence, whereas hyperlipidaemia was inversely associated (odds ratio 0.52, 95% CI 0.30 to 0.90).


CONCLUSIONS
Hypertension and diabetes were significant factors related to recurrent lacunar infarction. Hyperlipidaemia appeared to have a protective role. Cognitive impairment was a frequent finding in patients with multiple lacunar infarction recurrences.
Arboix
A
A
Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, Viladomat 288, E-08029 Barcelona, Spain. aarboix@hscor.com
Font
A
A
Garro
C
C
García-Eroles
L
L
Comes
E
E
Massons
J
J
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply; D020520:Brain Infarction / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D002391:Catchment Area, Health; D002560:Cerebrovascular Circulation / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D009483:Neuropsychological Tests; D012008:Recurrence; D012042:Registries; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology