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Long-term prognosis after lacunar infarction
Norrving B.. The Lancet. Neurology, 2003-04-01
Topic: Risk, prevention and care in population studies
Lacunar infarcts, small deep infarcts that result from occlusion of a penetrating artery, account for about a quarter of all ischaemic strokes. These infarcts have commonly been regarded as benign vascular lesions with a favourable long-term prognosis. However, recent studies have shown that this is only the case early in the disease course. A few years after infarct, there is an increased risk of death, mainly from cardiovascular causes. The risk of recurrent stroke after lacunar infarct is similar to that for most other types of stroke, and patients have an increased risk of developing cognitive decline and dementia. Age, vascular risk factors, high nocturnal blood pressure, and severity of cerebral small-vessel disease at onset have significant prognostic implications for almost all outcomes. More studies on mechanisms, prevention, and treatment are needed to provide specific guidance on the long-term management of patients with lacunar infarcts. Risk-factor modification is likely to play a large part in therapeutic interventions targeted at this stroke subtype.
Key findings
- Lacunar infarcts, small deep infarcts that result from occlusion of a penetrating artery, account for about a quarter of all ischaemic strokes.
- However, recent studies have shown that this is only the case early in the disease course.
- A few years after infarct, there is an increased risk of death, mainly from cardiovascular causes.
- The risk of recurrent stroke after lacunar infarct is similar to that for most other types of stroke, and patients have an increased risk of developing cognitive decline and dementia.
- Age, vascular risk factors, high nocturnal blood pressure, and severity of cerebral small-vessel disease at onset have significant prognostic implications for almost all outcomes.
Why it matters
This review reports that after lacunar infarction patients have an increased risk of cognitive decline and dementia, and that risk-factor modification is likely to play a large part in treatment. It does not report any proven treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Evidence strengthLow
How this study scored 44/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (The Lancet. Neurology) |
| Journal's citation record | 3 / 4 | The Lancet Neurology: journal h-index 457 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 263 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.5 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 3 / 6 | Cited 6.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 33 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Bo G Norrving: h-index 97 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Lund University: institution h-index 1,119 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12849212) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 44 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Norrving, B. (2003). Long-term prognosis after lacunar infarction. The Lancet. Neurology. https://doi.org/10.1016/s1474-4422(03)00352-1
Vancouver
Norrving B. Long-term prognosis after lacunar infarction. The Lancet. Neurology. 2003. doi:10.1016/s1474-4422(03)00352-1. PMID: 12849212.
BibTeX
@article{norrving2003-12849212,
author = {Norrving, B.},
title = {{Long-term prognosis after lacunar infarction}},
journal = {The Lancet. Neurology},
year = {2003},
doi = {10.1016/s1474-4422(03)00352-1},
pmid = {12849212},
url = {https://doi.org/10.1016/s1474-4422(03)00352-1}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.