الفهرس 
STROKEOnly 14 pages are availabe for public view
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Abstract
Introduction: Lacunar infarcts are small subcortical infarcts mainly located in the basal ganglia, internal capsule, thalamus, corona radiata and brainstem. About 20% of all strokes (about 25% of all ischemic stroke) are lacunar in type. Lacunar infarcts are considered to be caused by progressive lipohyalinosis and atherosclerosis of deep penetrating arteries. This study was designed to study the outcome in patients with lacunar stroke that received intravenous thrombolysis with recombinant tissue plasminogen activator to determine efficacy of IV thrombolysis in lacunar stroke.
Patients and Methods: 58 patients were included in the study who received IV thrombolysis. All were in-patients, admitted in the stroke unit either in Ain Shams University hospitals, mean age of patients (62.4 ±9.4). Patients were diagnosed by neurological history, clinical examination and radiological investigations (CT scan and MRI brain stroke protocol). All patients underwent stroke severity assessment using National Institutes of Health Stroke Scale (NIHSS) score and stroke disability assessment using modified Rankin Scale (mRS) score on admission, on discharge and after 3 months.
Results: Mean and Standard Deviation of both studied groups regarding age, gender, risk factors, NIHSS, MRS (N=58). Mean age (62.4 ±9.4), 72.4% males, 27.6% females, 20.7% smokers, 41.4% DM, 44.8% HTN, 10.3 % had previous stroke and 12.1% hyperlipidemic. NIHSS on admission (6.9±2.1). Regarding site of infarction in MRI 55% were capsular, 8.6 % thalamic, 36.2 % pontine and 0% cerebellar.size of infarct on MRI(8.6 ±2.8),3.4 % of patient complicated with hemorrhagic transformation, 3.4 % with brain oedema, mostly in the capsular division. 82.8 % improved significantly on discharge, 10.3 % unchanged, 3.4% worse prognosis, 3.4 % dead, NIHSS on discharge (3.9±1.3) , MRS (1.6±0.5). After 3 months 74.1% was unchanged regarding NIHSS and MRS, NIHSS after 3 month (3.09±4.1), MRS after 3 month (0.9±1.8).
Conclusion: There is high association between lacunar stroke and risk factors (DM, HTN). Internal capsule infarct is the most common site of lacunar stroke.