Functional outcome for patients with hemiparesis, hemihypesthesia, and hemianopsia : does lesion location matter ?

• Published in: Stroke (1970) Vol. 26; no. 11; pp. 2023 - 2026
• Main Authors: DROMERICK, A. W, REDING, M. J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.11.1995; American Heart Association, Inc
• Subjects: Aged; Biological and medical sciences; Brain - pathology; Cerebrovascular Disorders - complications; Cerebrovascular Disorders - pathology; Female; Hemianopsia - etiology; Hemianopsia - pathology; Hemiplegia - etiology; Hemiplegia - pathology; Humans; Hypesthesia - etiology; Hypesthesia - pathology; Male; Medical sciences; Middle Aged; Neurology; Predictive Value of Tests; Prognosis; Retrospective Studies; Syndrome; Vascular diseases and vascular malformations of the nervous system; Human; Hemiparesis; Sensitivity disorder; Nervous system diseases; Stroke; Hypoesthesia; Motor system disorder; Hemianopsia; Cardiovascular disease; Cerebral disorder; Vascular disease; Eye disease; Visual field disease; Central nervous system disease; Unilateral; Complication; Evolution; Lesion; Rehabilitation; Neurological disorder; Localization; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.26.11.2023

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. 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). 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). For patients with HHH deficits, the anatomic location of the lesion (C versus S versus M) does not affect functional outcome.