Studies on cerebrovascular stroke. III. Long-term prognosis and clinical findings in a follow-up study of a stroke material.

The present paper reports the third part of an investigation of first-time cerebrovascular strokes occurring in people under the age of 70. The long-term prognosis for 214 patients discharged alive from hospital after the acute phase of the stroke is presented. The clinical and laboratory findings for 114 patients alive at the time of a follow-up examination 32 months after the stroke are discussed. The long-term prognosis could be predicted best by a score, calculated from the neurological findings on admission after the acute stroke. Recurrence of stroke was associated with a very high mortality. Forty-five per cent of the patients who survived the first month had died by the time of follow-up. About 15% were able to return to normal life or go back to work. There was a trend among patients originally severely handicapped to improve their performance ability. Factors influencing the chances for rehabilitation are discussed. Among the survivors there was a strikingly high percentage of patients with overt diabetes or decreased glucose tolerance, of patients with arteriosclerotic heart disease and patients with elevated serum triglyceride levels. These findings are discussed.