ABSTRACT
OBJECTIVE: Evaluation of impairment and disability in stroke patients with a severe cortical infarction at admission as well as six months after the stroke. DESIGN: Prospective and descriptive study. SETTING: Rehabilitation Centre Heliomare, Wijk aan Zee, the Netherlands. METHODS: Between 1 January 1987 en 31 May 1992 stroke patients were admitted to the rehabilitation centre with a severe, first ever, cortical infarction without any comorbidity. The patients were dependent in activities of daily living and wheel-chair-bound. Motor and neuropsychological impairment and disability were evaluated at admission to the rehabilitation centre as well as six months after the stroke. Return to home and length of stay were evaluated. RESULTS: 43 patients were included. Recovery of arm and hand function was very poor (there was complete paresis at admission in 33 patients (77%) and six months after the CVA in 25 patients (58%)); recovery of the affected leg was reasonable (complete paresis in 10 (23%) and 0 patients, respectively). Cognitive deficits diminished in severity, but remained noticeable in three-quarters of the patients. Independent walking was achieved by 30 patients (70%), independence in personal activities of daily living by 32 patients (74%) and returning home by 36 patients (84%). The mean hospital stay was 26 weeks (SD: 9.26; range: 11-30). CONCLUSION: Prognosis of personal independence and returning home after a severe cortical infarction was rather good despite poor recovery of motor and cognitive impairment.
