1983 Volume 20 Issue 6 Pages 476-484
In 96 patients with supratentorial cerebral infarction, the recovery of activity of daily living (ADL) was studied in relation to computerized tomography (CT) findings in the acute stage. The average age was 64 and 78 out of 96 were first attack cases.
The cases were divided into 3 groups on the basis of the CT findings. The N group had no low density area on CT. The S group had a small deep infarct around the basal ganglia and the L group showed a large infarct with a damaged cerebral cortex.
Dilatation of the ventricles was measured by the methods of Meese and Huckman. Cortical atrophy estimated by summation of width of Sylvian fissures or parietal cortical sulci, expressed in percentages. Measurements for CT were performed in the subacute stage to exculde the effects of cerebral edema.
ADL was categorized in five stages using Rankin's criteria in the first week and after the eighth week. Among the 3 groups, the L group had the worst ADL when examined eight weeks later. On the contrary, the N group showed the greatest improvement.
Patients under 60 years old showed better recovery at the eight week, while in most patients aged 70 or more the improvement was less evident.
Dilatation of ventricles and severity of cortical atrophy increased in proportion to age, especially in cases of cerebral infarcts. In patients with ventricular dilatation or severe cerebral atrophy. ADL improvement was lower.
Recovery was low in cases with narrow cortical sulci. Recovery of ADL in reattack patients was lowest and larger dilatation of the ventricles than first attack cases was recognized.
The size of cerebral infarction, ADL in the first week, the dilatation of lateral ventricles, the severity of cortical atrophy and age were found to be important factors in functional recovery.