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Título

LACUNAR STROKE AS A PREDICTOR OF MORE FAVORABLE OUTCOMES: THE RELEVANCE OF BAMFORD CLASSIFICATION WHEN EVALUATING ISCHEMIC BRAIN EVENTS AND PROGNOSTIC PREDICTION

Resumo

Introduction: The occlusion of perforating arteries is often the cause of a ischemic stroke and it appears as a syndrome called lacunar syndrome (LACS). That description is made based on Bamford classification and its use can help handling a patient and in their prognostic evaluation. Goal: to investigate possible relations between lacunar and non-lacunar syndromes of a ischemic stroke, the severity of neurological deficit, and the early functional result in patients admitted in the emergency room. Method: This is a descriptive, analytic and transversal study. The variables that were analyzed were obtained by the use of the National Institutes of Health Stroke Scale (NIHSS) instruments, the Bamford classification, the modified Rankin Scale (mRS) and the Barthel Index. Results: The sample had 103 patients, most of them being men (n = 57; 55.3%) between ages 51-80 (n = 69; 67%). The LACS was seen in 26.2% (n = 27) of the patients and it showed a significant correlation (ρ = 0.46; p < 0.001) with better functional results (mRS). There was a greater sampling distribution in light incapacity levels (22.2%) and insignificant incapacity (29.6%) when compared to non-lacunar syndromes, which had a higher percentage in moderate to severe incapacity level (29%) and severe incapacity level (29%). The analysis of the independence of a patient during their daily activies showed a significant correlation between the LACS and the Barthel Index (ρ = 0.42; p < 0.001). It was possible to highlight higher percentage numbers on total dependence (17.8%) and on severe dependence (49.3%) in patients with non-lacunar syndromes. No case of total dependence was found on patients with LACS. Among those with severe neurological damage (NIHSS ≥ 16), 95% of them (n = 37) showed non-lacunar syndromes. The analysis of the correlation between LACS and NIHSS showed a significant number (ρ = -0.32; P < 0.001), so that the bigger the severity of the deficit the smaller was the distribution of patients with that stroke subtype. Conclusion: Lacunar Syndrome has a correlation with functional and independent results higher than non-lacunar syndrome does. Moreover, the neurological damage in patients with LACS tends to be lighter. That result reveals the importance of the right classification of the ischemic stroke as well as allows the establishment of parameters in order to better guide a patient’s rehabilitation.

Palavras Chave

Lacunar stroke; prognosis; functional state