Cognitive impairment before and after intracerebral haemorrhage: a systematic review
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REVIEW ARTICLE
Cognitive impairment before and after intracerebral haemorrhage: a systematic review Claire Donnellan 1
&
David Werring 2
Received: 7 May 2019 / Accepted: 12 November 2019 # Fondazione Società Italiana di Neurologia 2019
Abstract Introduction There is increasing interest in understanding cognitive dysfunction before and after Intracerebral haemorrhage (ICH), given the higher prevalence of dementia reported (ranging from 5 to 44%) for this stroke type. Much of the evidence to date examining cognitive impairment associated with cerebrovascular disease has tended to focus more on ischaemic stroke. The aim of this review was to identify and quantify studies that focused on cognitive dysfunction pre and post ICH. Methods We conducted a systematic search using databases PubMed, Science Direct, Scopus and PsycINFO to identify studies that exclusively assessed cognitive function pre and post ICH. Studies were included in the review if used a measure of global cognition and/or a neuropsychological battery to assess cognitive function. Nineteen studies were deemed relevant for inclusion, where n = 8 studies examined cognitive impairment pre ICH and n = 11 post ICH. Results Prevalence of cognitive impairment ranged between 9–29% for pre ICH and 14–88% for post ICH. Predictive factors identified for pre and post ICH were previous stroke, ICH volume and location and markers of cerebral amyloid angiopathy (CAA). Most common cognitive domains affected post ICH were information processing speed, executive function, memory, language and visuo-spatial abilities. Most common cognitive assessments tools were the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) for pre-existing cognitive impairment and the Mini-Mental State Examination for global cognition post ICH and the Trail Making Test where neuropsychological tests were used. Conclusion Cognitive impairment and dementia affected almost one-third of patients, whether assessed pre or post ICH. Keywords Intracerebral haemorrhage . Cognitive impairment . Dementia . Neuropsychological assessment . Stroke
Introduction Spontaneous, non-traumatic intracerebral haemorrhage (ICH) is defined as bleeding within the brain parenchyma and occurs without trauma or known bleeding causes such as an
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-019-04150-5) contains supplementary material, which is available to authorized users. * Claire Donnellan [email protected] 1
School of Nursing and Midwifery, Faculty of Health Sciences, University of Dublin Trinity College, 2 Clare Street, Dublin 2, Ireland
2
Stroke Research Centre, UCL Institute of Neurology, First Floor, Russell Square House, 10-12 Russell Square, London WC1B 5EH, UK
arteriovenous malformation, cerebral aneurysm or tumour [1]. ICH accounts for 10–15% of all strokes worldwide. The overall incidence of ICH is reported to range between 15 and 40 cases per 100,000, but might be higher in Asian populations, and has increased in individuals over 75
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