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Presentation and Prognosis

Ross L. Levine, MD; Hans L. Lagreze, MD; Jeffrey A. Dobkin, MD; Patrick A. Turski, MD

Arch Neurol. 1988;45(10):1074-1077.

Abstract
• A specific form of large subcortical hemispheric infarction on computed tomography was identified in 24 of 2198 (1%) stroke registry patients. Combined with 13 cases from earlier literature reports, a characteristic neurologic picture developed. Severe face plus arm plus leg weakness at onset (76%), corticallike features of aphasia and/or contralateral neglect (68%), and premonitory transient ischemic attacks (24%) were frequent. Twenty-two patients (59%) had large vessel arterial occlusive disease. Eight patients (22%) had primary embolic occlusion in the middle cerebral artery territory. During an average follow-up of 16 months, five patients (14%) suffered recurrent stroke or death. The clinical presentation and prognostic features of this distinct stroke subtype are described.

Author Affiliations
From the Departments of Neurology (Drs Levine, Lagreze, and Dobkin), and Radiology (Drs Levine and Turski), William S. Middleton Veterans Administration Hospital and University of Wisconsin Hospitals, Madison.

Footnotes
Accepted for publication June 20, 1988.

Reprint requests to Department of Neurology 127, Middleton Veterans Administration Hospital, 2500 Overlook Terr, Madison, WI 53705 (Dr Levine).

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