Abstract
BACKGROUND: Stroke, the second leading cause of global death, includes ischemic strokes, which account for 71% of cases. Lacunar infarcts, small ischemic lesions due to small vessel occlusion, represent about 25% of ischemic strokes. This study investigates the demographic, clinical characteristics, and outcomes of lacunar stroke patients in Tabriz, Iran, where such data are limited. METHODS: This cross-sectional study utilized data from 251 patients with acute lacunar stroke, collected from the Neuroscience Research Center (NSRC) registry at Tabriz University of Medical Sciences, covering January 2019 to January 2023. Diagnosis was confirmed using FLAIR and DW-MRI, with lacunar infarcts defined per STRIVE criteria. Functional outcomes were measured using the modified Rankin Scale (mRS) at admission, discharge, and 90 days post-stroke. Data were analyzed using SPSS version 27. RESULTS: The cohort had a median age of 60 years, with 159 males and 92 females. Hypertension (70.1%) and diabetes mellitus (37.1%) were the most common risk factors. Dysarthria (53.8%) and motor deficits (right upper limb 43.8%, lower limb 41.8%) were prevalent. Pre-stroke mRS scores showed no disability in 80.88% of patients. By discharge, most had mRS scores of 1 or 2. At 90 days, 27.49% had fully recovered. The 90-day case fatality rate was 3.19%, with 3.2% experiencing complications. CONCLUSIONS: Hypertension and diabetes mellitus are critical risk factors for lacunar stroke. The study indicates generally favorable outcomes with appropriate management. Findings highlight the need for ongoing risk factor control and suggest further multicenter studies to validate results and explore long-term outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-025-04264-8.