Defects and the Prognosis of Stroke Patients

• The prognosis of stroke patients is related to the presence or absence of homonymous hemianopia at time of admission to a stroke center. Two hundred thirty-four patients were followed for an average of 15 months. In patients with nonhemorrhagic strokes in the middle cerebral artery territory the presence of a dense homonymous hemianopia lasting for more than 24 hours, together with any degree of motor, sensory or speech defect, seemed to affect adversely the potential for rehabilitation and survival. Data were insufficient to draw similar conclusions with other types of cerebrovascular lesions. The pertinent literature is briefly reviewed. Additional Key Words homonymous hemianopia rehabilitative potential stroke center middle cerebral artery territory thrombosis survival • Stroke centers are an increasing and somewhat controversial phenomenon in American medicine. They may be primarily research or patient-care oriented. One of the problems in a patient-care oriented stroke center is that of selection of patients for admission. This work represents an initial attempt to identify some of the factors which might help the physician determine which patients would benefit most from admission to a ' stroke center of limited size which is thus unable to accommodate all referred patients. Can the prognosis and rehabilitative potential of patients with various types of cerebrovascular disease reasonably be predicted from some of their initial or presenting clinical findings? While it is obvious that a 99-year-old, comatose, quadriplegic, severely diabetic, hypertensive and uremic patient has a poor rehabilitative potential, it is not as obvious which conscious patients without other serious disease may have reasonable rehabilitative potential. Therefore, it was decided to evaluate the possible prognostic significance of visual field defects at the time the patient is first presented for admission to a stroke center