Cognitive Impairment After Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis

Kazim, Syed Faraz; Ogulnick, Jonathan; Robinson, Myranda B.; Eliyas, Javed Khader; Spangler, Benjamin Q.; Hough, Tyler; Martinez, Erick; Karimov, Zafar; Vidrine, Devan W.; Schmidt, Meic H.; Bowers, Christian A.

doi:10.1016/j.wneu.2021.01.026

Cited by 23 publications

(10 citation statements)

References 66 publications

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“…In a similar fashion, various clinic-pathologic studies have linked the presence of intracerebral hemorrhage with cognitive impairment and decline [128] , [129] , [130] . The mechanisms by which hemorrhages or microbleeds cause cognitive impairment in aging are still debated and may be dependent on the underlying etiology of the hemorrhages.…”

Section: Clinical Pathological Correlates Of Vascular Pathologiesmentioning

confidence: 88%

Vascular pathology and pathogenesis of cognitive impairment and dementia in older adults

Agrawal

Schneider²

2022

Cerebral Circulation - Cognition and Behavior

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Section: Clinical Pathological Correlates Of Vascular Pathologiesmentioning

confidence: 88%

Vascular pathology and pathogenesis of cognitive impairment and dementia in older adults

Agrawal

Schneider²

2022

Cerebral Circulation - Cognition and Behavior

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“…Cerebral amyloid angiopathy (CAA) is a form of cerebral small vessel disease that is a common cause of intracerebral hemorrhage and a contributor to cognitive impairment 1–3 . CAA commonly co‐occurs with parenchymal β‐amyloid deposition (as in Alzheimer's disease) but can also occur independently 4 .…”

mentioning

confidence: 99%

Progressive White Matter Injury in Preclinical Dutch Cerebral Amyloid Angiopathy

Shirzadi

Yau

Schultz

et al. 2022

Annals of Neurology

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Autosomal‐dominant, Dutch‐type cerebral amyloid angiopathy (D‐CAA) offers a unique opportunity to develop biomarkers for pre‐symptomatic cerebral amyloid angiopathy (CAA). We hypothesized that neuroimaging measures of white matter injury would be present and progressive in D‐CAA prior to hemorrhagic lesions or symptomatic hemorrhage. In a longitudinal cohort of D‐CAA carriers and non‐carriers, we observed divergence of white matter injury measures between D‐CAA carriers and non‐carriers prior to the appearance of cerebral microbleeds and >14 years before the average age of first symptomatic hemorrhage. These results indicate that white matter disruption measures may be valuable cross‐sectional and longitudinal biomarkers of D‐CAA progression. ANN NEUROL 2022;92:358–363

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“…Of note, the vast majority of reviewed studies used poor functional outcome/severe disability—defined heterogeneously as a modified Rankin Scale (mRS) of ≥ 3, an mRS of ≥ 4, or a Glasgow Outcome Score ≤ 3—and/or mortality, reported at varying time points, as their main outcomes of interest. Relatively few studies at the level of full-text screening examined cognitive status [ 133 , 134 ] or quality of life, so the creation of formal recommendations regarding these two outcomes were ultimately deferred.…”

Section: Methodsmentioning

confidence: 99%

Guidelines for Neuroprognostication in Critically Ill Adults with Intracerebral Hemorrhage

Hwang,

Kim,

Muehlschlegel

et al. 2023

Neurocrit Care

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Background The objective of this document is to provide recommendations on the formal reliability of major clinical predictors often associated with intracerebral hemorrhage (ICH) neuroprognostication. Methods A narrative systematic review was completed using the Grading of Recommendations Assessment, Development, and Evaluation methodology and the Population, Intervention, Comparator, Outcome, Timing, Setting questions. Predictors, which included both individual clinical variables and prediction models, were selected based on clinical relevance and attention in the literature. Following construction of the evidence profile and summary of findings, recommendations were based on Grading of Recommendations Assessment, Development, and Evaluation criteria. Good practice statements addressed essential principles of neuroprognostication that could not be framed in the Population, Intervention, Comparator, Outcome, Timing, Setting format. Results Six candidate clinical variables and two clinical grading scales (the original ICH score and maximally treated ICH score) were selected for recommendation creation. A total of 347 articles out of 10,751 articles screened met our eligibility criteria. Consensus statements of good practice included deferring neuroprognostication—aside from the most clinically devastated patients—for at least the first 48–72 h of intensive care unit admission; understanding what outcomes would have been most valued by the patient; and counseling of patients and surrogates whose ultimate neurological recovery may occur over a variable period of time. Although many clinical variables and grading scales are associated with ICH poor outcome, no clinical variable alone or sole clinical grading scale was suggested by the panel as currently being reliable by itself for use in counseling patients with ICH and their surrogates, regarding functional outcome at 3 months and beyond or 30-day mortality. Conclusions These guidelines provide recommendations on the formal reliability of predictors of poor outcome in the context of counseling patients with ICH and surrogates and suggest broad principles of neuroprognostication. Clinicians formulating their judgments of prognosis for patients with ICH should avoid anchoring bias based solely on any one clinical variable or published clinical grading scale.

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Cognitive Impairment After Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis

Cited by 23 publications

References 66 publications

Vascular pathology and pathogenesis of cognitive impairment and dementia in older adults

Vascular pathology and pathogenesis of cognitive impairment and dementia in older adults

Progressive White Matter Injury in Preclinical Dutch Cerebral Amyloid Angiopathy

Guidelines for Neuroprognostication in Critically Ill Adults with Intracerebral Hemorrhage

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