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Dr. Barrett has very important questions but unfortunately our study was not designed and, therefore not powered, to provide an appropriate answer. After exclusion of the 22 patients who died, and of the 69 patients whose infarcts were located in the posterior fossa or multiple, 196 survivors had a clearly defined unilateral hemispheric infarct (right hemisphere 101; left hemisphere 95). In the follow-up period, a divorce was reported in 10 patients with a right hemispheric infarct and five with a left hemispheric infarct (odds ratio: 1.98; 95% confidence interval: 0.05- 6.02). Of the 196 survivors with an unilateral hemispheric infarct, seven patients with right-hemispheric lesions did not return to work despite an apparently good recover, as defined in our paper , and three with left hemispheric infarcts (odds ratio: 2.28; 95% confidence interval: 0.57- 9.10).
Therefore, because of the low power of the statistical tests our study cannot help to answer the question of whether right hemispheric infarcts lead more often than left hemispheric infarcts to social or family impairment in young patients with ischemic infarcts. A larger group of patients would be necessary.
1)Leys D, Bandu L, Hénon H, et al. Clinical outcome in 287 consecutive young adults (15-45 years) with ischemic stroke. Neurology 2002;59:26-33.
I read with interest the report of Leys et al. on clinical outcome in young ischemic stroke. 
Disorders of emotional processing and communication are common after right hemisphere stroke , and a common clinical teaching is that divorce occurs more frequently after right hemisphere than left hemisphere injury. Were right hemisphere stroke patients over-represented among their 20 patients reporting post-stroke divorce?
Spatial neglect is also highly associated with right hemisphere injury and post-stroke disability.  Was there a preponderance of right hemisphere injury in those patients who did not return to work, particularly those regarded employable by their health insurance?
1)Leys D, Bandu L. Hénon H, Lucas C, et al. Clinical outcome in 287 consecutive adults (15 to 45 years) with ischemic stroke. Neurology 2002;59:26-33.
2)Heilman KM, Blonder LX, Bowers D, Crucian GP. Neurological disorders and emotional dysfunction. In: Borod JC, ed. The neuropsychology of emotion. NY: Oxford University Press, 2000.
3)Paolucci S, Antonucci G, Grasso MG, Pizzamiglio L. The role of unilateral spatial neglect in rehabilitation of right-brain-damaged ischemic stroke patients: A matched comparison. Arch Phys Med Rehab 2001;82:743-749.
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