title: Comparison of Functional Outcome between Lacunar Infarction and Branch Atheromatous Disease in Lenticulostriate Artery Territory.
abstract: BACKGROUND
  Branch atheromatous disease (BAD) is differentiated from lacunar infarction (LI). BAD is often associated with neurological deterioration in the acute stage, but outcome of BAD patients in the chronic stage is unclear. We aimed to explore the outcome of BAD in the lenticulostriate artery (LSA) territory in comparison with those of LI from the viewpoint of activities of daily living (ADLs).
  
  
  METHODS
  We retrospectively investigated patients who were admitted within 3 days after stroke onset. The patients underwent daily rehabilitation during hospitalization. BAD in LSA territory was defined by the presence of lesion representing 3 or more consecutive horizontal slices in magnetic resonance imaging. Patients having atrial fibrillation or more than 50% stenosis of the large artery in magnetic resonance angiography were excluded. We retrieved data on clinical characteristics and evaluation from medical records.
  
  
  RESULTS
  Subjects were 41 BAD and 35 LI patients. There was little difference in baseline characteristics. The National Institutes of Health Stroke Scale score was significantly higher in BAD patients (P < .05). The Barthel Index (BI) score and the Brunnstrom recovery stage were lower in BAD patients at admission (P < .05 and P < .05). Hospital stay was longer in BAD patients (P < .01), but the BI score at discharge was not different. To ambulate, 8 BAD and 1 LI patients depended on orthoses (P < .05), and 21 BAD and 7 LI patients used canes (P < .01). Multivariable analysis demonstrated that BAD lesion was correlated with AFO use independent of age and sex.
  
  
  CONCLUSIONS
  BAD patients can obtain ADLs similar to LI patients. However, many BAD patients require canes and/or orthoses.
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: pomardon2010@gmail.com.
authors.forename: Masachika
authors.initials: M
authors.lastname: Niimi
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Abo
authors.affiliation: Department of Rehabilitation, Tokyo General Hospital, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miyano
authors.affiliation: Department of Rehabilitation Medicine, International University of Health and Welfare Atami Hospital, Atami, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sasaki
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020144:Basal Ganglia Cerebrovascular Disease / Q000150:complications* / Q000000981:diagnostic imaging; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D059409:Stroke, Lacunar / Q000000981:diagnostic imaging / Q000209:etiology*
keywords: ADL; BAD; neurorehabilitation; orthosis; rehabilitation; stroke