Lacunar infarctions account for about one-fifth of first-ever strokes and have a relatively low 1-year case fatality but a notable 1-year recurrence rate.
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Lacunar stroke shows low 1-year fatality yet notable recurrence; extends observational prognosis data while leaving optimal prevention open.
In a consecutive series of 515 first-ever strokes in a community-based study of stroke that combined prompt clinical assessment by a study neurologist with a high rate of confirmed pathologic diagnosis, 108 cases (21%) had a lacunar syndrome. A computed tomography (CT) scan was performed in 104 (96%) of these cases. Only 3 cases had primary intracerebral hemorrhage, and another 3 had "inappropriate" areas of infarcts were seen in 34 of the remaining 98 (35%) CT scans. The crude annual incidence of lacunar infarction was 0.33/1,000. There was no excess risk among men. The case fatality rates were 1% at 1 month and 9.8% at 1 year. The rate of recurrent strokes was 11.8% in the first year. Among patients surviving 1 year, 66% were capable of independent existence.
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Bamford et al. (1987) studied this question.
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