Title :

Long-term cognitive outcomes after decompressive hemicraniectomy for right-hemisphere large middle cerebral artery ischemic stroke

Author(s) :

Scopelliti, Giuseppe [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Henon, Hilde [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Labreuche, Julien [Auteur]
Service de Biostatistiques [CHRU Lille]
Kuchcinski, Gregory [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Aboukais, Rabih [Auteur]
Département de Neurochirurgie[Lille]
Cordonnier, Charlotte [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Casolla, Barbara [Auteur]
Université Côte d'Azur [UniCA]

Journal title :

European Journal of Neurology

Abbreviated title :

Eur. J. Neurol.

Volume number :

32

Pages :

e16492

Publisher :

Wiley Online Library

Publication date :

2024-11-18

ISSN :

1351-5101

English keyword(s) :

cognitive impairment
decompressive hemicraniectomy
ischemic stroke

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background and Purpose Decompressive hemicraniectomy (DH) improves survival and functional outcome in large middle cerebral artery (MCA) infarcts. However, long-term cognitive outcomes after DH remain underexplored. In a ...
Show more >Background and Purpose Decompressive hemicraniectomy (DH) improves survival and functional outcome in large middle cerebral artery (MCA) infarcts. However, long-term cognitive outcomes after DH remain underexplored. In a cohort of patients with large right-hemisphere MCA infarction undergoing DH, we assessed the rates of long-term cognitive impairment over 3-year follow-up. Methods We prospectively evaluated consecutive patients included in the Lille Decompressive Surgery Database (May 2005–April 2022) undergoing DH according to existing guidelines for large hemisphere MCA infarction. We included patients with right-sided stroke and screened with the Mini-Mental State Examination (MMSE) in at least one of the prespecified follow-ups (3-month, 1-year, 3-year). Cognitive impairment was defined as an MMSE score < 24. We included only right-hemisphere strokes to avoid testing biases related to severe aphasia. We compared clinical and neuroimaging data in patients with and without cognitive impairment. Results Three hundred four patients underwent DH during the study period. Among 3-month survivors, 95 had a right-hemisphere stroke and underwent at least one cognitive screening (median age = 51 years, 56.8% men). Forty-four patients (46.3%) exhibited cognitive impairment at least once during the 3-year follow-up. Baseline characteristics did not significantly differ between patients with and without cognitive impairment. Regarding long-term temporal trends, cognitive impairment was observed in 23 of 76 (30.3%), 25 of 80 (31.3%), and 19 of 66 (28.8%) patients at 3-month, 1-year, and 3-year follow-up, respectively, and it was associated with higher rates of functional disability (all p < 0.05). Conclusions The persistently high rates of cognitive impairment after DH highlight the importance of cognitive monitoring to improve the long-term management of survivors.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Submission date :

2025-01-31T22:02:45Z
2025-02-26T09:54:20Z