%0 Journal Article
%T Cheyne-Stokes Respiration in Patients with First-Ever Lacunar Stroke
%A Marc Bonnin-Vilaplana
%A Adri¨¤ Arboix
%A Olga Parra
%A Luis Garc¨ªa-Eroles
%A Josep M. Montserrat
%A Joan Massons
%J Sleep Disorders
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/257890
%X The aim of this single-center prospective study was to assess the presence of Cheyne-Stokes respiration (CSR) and CSR-related variables in 68 consecutive patients with radiologically proven first-ever lacunar stroke undergoing a respiratory sleep study using a portable respiratory polygraph within the first 48 hours of stroke onset. CSR was diagnosed in 14 patients (20.6%). Patients with CSR as compared with those without CSR showed a significantly higher mean (standard deviation, SD) apnea-hypopnea index (AHI) (34.9 (21.7) versus 18.5 (14.4), ) and central apnea index (13.1 (13.8) versus 1.8 (3.4), ) as well as higher scores of the Barthel index and the Canadian Neurological scale as a measure of stroke severity, and longer hospital stay. CSR was present in one of each five patients with lacunar stroke. The presence of CSR was associated with a trend towards a higher functional stroke severity and worse prognosis. 1. Introduction Central sleep apnea and Cheyne-Stokes respiration are frequently observed during sleep in patients with stroke affecting large areas of the cerebral parenchyma [1¨C5] and in patients with congestive heart failure and low ventricular ejection fraction [6¨C10]. In a previous study carried out in a nonselected sample of patients with cerebral infarction, Parra et al. [11] reported the presence of Cheyne-Stokes respiration in 26% of patients, a percentage higher than 6% of observed in the study of Bassetti and Aldrichet [12]. To date, Cheyne-Stokes respiration in stroke patients has been related to a worse prognosis probably because this abnormal breathing pattern is found in more extensive cerebral lesions and is also more common in hemorrhagic strokes than in ischemic infarctions [11, 13]. However, the traditional relationship between nocturnal Cheyne-Stokes respiration and large cerebral lesions is a matter of controversy given that Cheyne-Stokes respiration has been occasionally described in patients with transient ischemic attack (TIA) [11]. Lacunar infarctions are very homogeneous cerebral lesions regarding infarct size (maximal diameter of the lesion <20£¿mm), topography (affecting subcortical structures or the pons), and clinical features (limited neurological deficit and favorable neurological recovery on hospital discharge). In this respect, patients with lacunar stroke may constitute an intermediate group of stroke severity between TIA and extensive cardioembolic or atherothrombotic infarctions. Given that the presence of Cheyne-Stokes respiration in patients with lacunar infarction has not been previously examined, a
%U http://www.hindawi.com/journals/sd/2012/257890/