Factors Related to Early Neurological Deterioration in Lacunar Stroke and Its Influence on Functional Outcome | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2025, Issue 4, April 2025, Page 285-290 PDF (334.37 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/aimj.2025.446538 | ||||
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| Authors | ||||
| Emad Fawzy Shahin; Fathy Mahmoud Mansour; Ahmed Abdel Nasser Anwar | ||||
| Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Up to 20 percent of cerebral infarcts are caused by lacunar infarction. Although patients with lacunar infarction often have a good prognosis, there is a substantial chance of early neurological degeneration(END), which can have a negative impact on their recovery. Aim and objectives: Identifying risk variables for end-stage neuropathy (END) and its impact on functional outcome in patients with acute lacunar stroke. Subjects and methods: From May 2024 through November 2024, fifty patients hospitalized to the emergency department and stroke unit at Al-Azhar University hospitals (Al-Hussien and Bab El-Shaeria) with symptoms of acute ischemic stroke were participating in this prospective study. Results: Metabolic risk factors were prominent, with HbA1c at 7.5(SD=2.8), triglycerides 165.4 mg/dL(SD=38.0), and LDL cholesterol 167.5 mg/dL(SD=36.5), underscoring the role of dyslipidemia and poor glycemic control in stroke pathophysiology. Neurological severity was moderate at baseline(NIHSS=6.4, SD=2.5) with some deterioration(mean change=1.4, SD=1.2). However, functional outcomes improved, with mRS decreasing from 2.0 at discharge to 1.0 at three months, reflecting recovery with proper management. Conclusion: Elevated HbA1c and LDL cholesterol levels were strongly associated with deterioration, emphasizing the role of metabolic control in stroke progression. The baseline NIHSS score emerged as the most significant predictor of deterioration, underscoring the importance of initial stroke severity assessment. The logistic regression and discriminant function models demonstrate high predictive accuracy, reinforcing their utility in clinical decision-making. | ||||
| Keywords | ||||
| Lacunar stroke; Neurological deterioration; Risk factors | ||||
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