{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T03:36:26Z","timestamp":1778124986799,"version":"3.51.4"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Lacunar stroke (LS) is responsible for one-quarter of the overall number of ischemic strokes with long-term complications and carries health and economic issues for patients and health care systems. Therefore, we aimed to investigate lacunar versus non-lacunar strokes in a tertiary academic center. From February 2016 to July 2019, all patients admitted to the stroke unit were retrospectively reviewed. We included LS patients and compared them to other TOAST subtypes. Hemorrhagic stroke and conditions mimicking stroke were excluded. Regression analysis was done to determine LS predictors and outcomes. A 35.5% rate of LS among 989 ischemic stroke patients was found. Most patients (71.9%) were males. Lower National Institutes of Health Stroke Scale (NIHSS) scores at admission and negative history for cardiac diseases were predictors for LS in our population. At discharge, LS patients had low NIHSS scores and shorter hospitalization periods compared to non-LS patients. In conclusion, LS was prevalent among ischemic stroke patients in our cohort. Future studies are highly needed with long follow-up intervals to identify the stroke recurrence, complications, and outcomes.<\/jats:p>","DOI":"10.3390\/brainsci11111466","type":"journal-article","created":{"date-parts":[[2021,11,7]],"date-time":"2021-11-07T20:41:14Z","timestamp":1636317674000},"page":"1466","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prevalence and Clinical Characteristics of Lacunar Stroke: A Hospital-Based Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9855-8106","authenticated-orcid":false,"given":"Mohammed A.","family":"Aldriweesh","sequence":"first","affiliation":[{"name":"College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed A.","family":"Alluhidan","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11564, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bayan A.","family":"Al Bdah","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muath A.","family":"Alhasson","sequence":"additional","affiliation":[{"name":"Unaizah College of Medicine, Qassim University, Buraydah 56219, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sultan A.","family":"Alsaif","sequence":"additional","affiliation":[{"name":"College of Medicine, Almaarefa University, Riyadh 13713, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abrar A.","family":"Alajlani","sequence":"additional","affiliation":[{"name":"College of Medicine, Almaarefa University, Riyadh 13713, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faisal M.","family":"Almutairi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed A.","family":"Alskaini","sequence":"additional","affiliation":[{"name":"Department of Neurology, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naser","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"},{"name":"Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali M.","family":"Al Khathaami","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"},{"name":"Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S1474-4422(18)30499-X","article-title":"Global, Regional, and National Burden of Neurological Disorders, 1990\u20132016: A Systematic Analysis for the Global Burden of Disease Study 2016","volume":"18","author":"Feigin","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e259","DOI":"10.1016\/S2214-109X(13)70089-5","article-title":"Global and Regional Burden of First-Ever Ischaemic and Haemorrhagic Stroke during 1990-2010: Findings from the Global Burden of Disease Study 2010","volume":"1","author":"Krishnamurthi","year":"2013","journal-title":"Lancet Glob. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"104465","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.104465","article-title":"An Epidemiological Model for First Stroke in Saudi Arabia","volume":"29","author":"Salawati","year":"2020","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1161\/01.STR.24.1.35","article-title":"Classification of Subtype of Acute Ischemic Stroke. Definitions for Use in a Multicenter Clinical Trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment","volume":"24","author":"Adams","year":"1993","journal-title":"Stroke"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1161\/STROKEAHA.119.024148","article-title":"Clinical Relevance of Cerebral Small Vessel Diseases","volume":"51","author":"Pasi","year":"2020","journal-title":"Stroke"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1136\/jnnp-2021-326308","article-title":"Lacunar Stroke: Mechanisms and Therapeutic Implications","volume":"92","author":"Yaghi","year":"2021","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1001\/jamaneurol.2018.1073","article-title":"Advances in Understanding the Pathophysiology of Lacunar Stroke","volume":"75","author":"Regenhardt","year":"2018","journal-title":"JAMA Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1161\/STROKEAHA.115.009485","article-title":"Genetic Architecture of Lacunar Stroke","volume":"46","author":"Traylor","year":"2015","journal-title":"Stroke"},{"key":"ref_9","first-page":"246","article-title":"Risk Factors and Subtypes of Acute Ischemic Stroke: A Study at King Fahd Hospital of the University","volume":"21","author":"Zafar","year":"2016","journal-title":"Neurosci. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2","DOI":"10.5853\/jos.2015.17.1.2","article-title":"Lacunar Infarction and Small Vessel Disease: Pathology and Pathophysiology","volume":"17","author":"Caplan","year":"2015","journal-title":"J. Stroke"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1136\/jnnp.2004.039982","article-title":"What Causes Lacunar Stroke?","volume":"76","author":"Wardlaw","year":"2005","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1161\/01.STR.0000157949.34986.30","article-title":"Are Lacunar Strokes Really Different?","volume":"36","author":"Jackson","year":"2005","journal-title":"Stroke"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.numecd.2007.02.003","article-title":"Diabetic and Non-Diabetic Subjects with Ischemic Stroke: Differences, Subtype Distribution and Outcome","volume":"18","author":"Tuttolomondo","year":"2008","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1212\/WNL.0b013e3181aa52ea","article-title":"Prevalence, Incidence, and Risk Factors of Lacunar Infarcts in a Community Sample","volume":"73","author":"Chen","year":"2009","journal-title":"Neurology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1136\/jnnp-2012-303645","article-title":"Cognitive Impairment after Lacunar Stroke: Systematic Review and Meta-Analysis of Incidence, Prevalence and Comparison with Other Stroke Subtypes","volume":"84","author":"Makin","year":"2013","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/ene.12626","article-title":"Post-Stroke Cognitive Decline: An Update and Perspectives for Clinical Research","volume":"22","author":"Brainin","year":"2015","journal-title":"Eur. J. Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1212\/WNL.46.1.154","article-title":"Dementia after Ischemic Stroke","volume":"46","author":"Kokmen","year":"1996","journal-title":"Neurology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1136\/jnnp-2018-319134","article-title":"Functional, Cognitive and Physical Outcomes 3 Years after Minor Lacunar or Cortical Ischaemic Stroke","volume":"90","author":"Mchutchison","year":"2019","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1111\/ane.12961","article-title":"Outcome in Lacunar Stroke: A Cohort Study","volume":"138","author":"Mantero","year":"2018","journal-title":"Acta Neurol. Scand."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1212\/WNL.0000000000001331","article-title":"Long-Term Disability after Lacunar Stroke: Secondary Prevention of Small Subcortical Strokes","volume":"84","author":"Dhamoon","year":"2015","journal-title":"Neurology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1177\/2396987316654338","article-title":"The Epidemiology of Stroke in the Middle East","volume":"1","author":"Salameh","year":"2016","journal-title":"Eur. Stroke J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1212\/01.wnl.0000210457.89798.0e","article-title":"A Population-Based Study of the Incidence and Prognosis of Lacunar Stroke","volume":"66","author":"Sacco","year":"2006","journal-title":"Neurology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1161\/STROKEAHA.107.510933","article-title":"Trends in Incidence, Risk Factors, and Survival in Symptomatic Lacunar Stroke in Dijon, France, From 1989 to 2006","volume":"39","author":"Bejot","year":"2008","journal-title":"Stroke"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1136\/jnnp.2010.222919","article-title":"Incidence of Aetiological Subtypes of Stroke in a Multi-Ethnic Population Based Study: The South London Stroke Register","volume":"82","author":"Hajat","year":"2011","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1161\/hs1201.100209","article-title":"Epidemiology of Ischemic Stroke Subtypes According to TOAST Criteria","volume":"32","author":"Weber","year":"2001","journal-title":"Stroke"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1136\/jnnp.2008.150318","article-title":"Ischaemic Stroke Subtypes and Associated Risk Factors: A French Population Based Study","volume":"79","author":"Bejot","year":"2008","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/9589831","article-title":"TOAST Subtypes of Ischemic Stroke and Its Risk Factors: A Hospital-Based Study at Cipto Mangunkusumo Hospital, Indonesia","volume":"2018","author":"Harris","year":"2018","journal-title":"Stroke Res. Treat."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1177\/1747493016684843","article-title":"Incidence, Recurrence, and Long-Term Survival of Ischemic Stroke Subtypes: A Population-Based Study in the Middle East","volume":"12","author":"Saber","year":"2017","journal-title":"Int. J. Stroke"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1161\/STROKEAHA.117.020031","article-title":"Distribution and temporal trends from 1993 to 2015 of ischemic stroke subtypes: A systematic review and meta-analysis","volume":"49","author":"Ornello","year":"2018","journal-title":"Stroke."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1586\/14737175.9.2.179","article-title":"Lacunar Stroke","volume":"9","author":"Arboix","year":"2009","journal-title":"Expert Rev. Neurother."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.05.006","article-title":"Pathophysiology of Lacunar Stroke: History\u2032s Mysteries and Modern Interpretations","volume":"28","author":"Regenhardt","year":"2019","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1136\/jnnp-2016-315324","article-title":"Prevalence, Risk Factors and Consequences of Cerebral Small Vessel Diseases: Data from Three Asian Countries","volume":"88","author":"Hilal","year":"2017","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1586\/14737175.2015.1049997","article-title":"Clinical Characteristics of Acute Lacunar Stroke in Young Adults","volume":"15","author":"Arboix","year":"2015","journal-title":"Expert Rev. Neurother."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2689","DOI":"10.1161\/STROKEAHA.114.005018","article-title":"Lacunar Strokes in Patients With Diabetes Mellitus: Risk Factors, Infarct Location, and Prognosis","volume":"45","author":"Palacio","year":"2014","journal-title":"Stroke"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/11\/11\/1466\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:26:41Z","timestamp":1760167601000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/11\/11\/1466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,5]]},"references-count":34,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["brainsci11111466"],"URL":"https:\/\/doi.org\/10.3390\/brainsci11111466","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,5]]}}}