Prevalence and short‐term changes of cognitive dysfunction in young ischaemic stroke patients

Abstract

Background and purpose Information on the prevalence and course of post‐stroke cognitive impairment in young stroke patients is limited. The aim was to assess a consecutive sample of acute young ischaemic stroke patients (18–55 years) for the presence and development of neuropsychological deficits. Methods Patients prospectively underwent a comprehensive clinical and cognitive assessment, examining general cognitive function, processing speed, attention, flexibility/executive function and word fluency within the first 3 weeks after hospital admission (median assessment at day 6) and at a 3 months’ follow‐up (FU). Cognitive dysfunction was defined in comparison to age‐standardized published norms. Results At baseline (N = 114), deficits were highly prevalent in processing speed (56.0%), flexibility/executive function (49.5%), attention (46.4%) and general cognitive function (42.1%). These frequencies were comparable for those with FU assessment (N = 87). In most domains, cognitive performance improved within 3 months, except for word fluency. However, in about one‐third of patients, cognitive deficits (as defined by 1.5 standard deviations below the standardized mean) were still present 3 months after stroke. At FU, 44.0% were impaired in the domain flexibility/executive function, 35.0% in processing speed and 30.0% in attention. Conclusions The high prevalence of cognitive deficits in acute young patients with ischaemic stroke highlights the importance of early post‐stroke cognitive assessment to capture a patient's dysfunction in a comprehensive manner and to offer adequate rehabilitation. The role of factors which promote neuropsychological deficits needs further exploration.

Understanding the seriousness of a stroke is essential for appropriate help-seeking and early arrival at a stroke centre: A cross-sectional study of stroke patients and their bystanders

“…Acute cognitive impairment frequently occurs after acute stroke and even TIA. 24,25 Hence, understanding the situation surrounding an acute stroke may be improved by interviewing the bystanders. Therefore, including bystanders is important to fully understand patient- and bystander-related predictors of delay.…”

Validation of the Spanish Version of Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL)

“…First of all, because it was developed following patient-centered methods and it includes all the relevant aspects, from patients´point of view and perspective, which may be present after a stroke. Besides, it can be administered to patients who suffered either hemorrhagic or ischemic stroke, since the clinical manifestations are similar [7][8][9]19]. The present study followed the original questionnaire methodology.…”

“…In Spain, about 4% of the people over 65 years of age live with very disabling sequelae of stroke [5,6]. There is a wide variety of clinical manifestations, such as motor, sensory, perception and cognitive disturbances, urinary and fecal incontinence, swallowing and visual problems, pain, communication, and behavioral alterations [7][8][9][10][11][12][13][14][15][16]. These symptoms affect activities of daily life (ADL), increase the risk of falls, and have a negative impact on quality of life (QoL) [17][18][19][20][21][22].…”

Cystatin C is a potential predictor of unfavorable outcomes for cerebral ischemia with intravenous tissue plasminogen activator treatment: A multicenter prospective nested case–control study

“…Severity of ischemic stroke was assessed with the National Institutes of Health Stroke Scale (NIHSS) [18,19]. Clinical outcome at 3 months after IV‐tPA was assessed by the mRS [20,21].…”