22. European Stroke Conference 414 Behavioral disorders and post-stroke dementia Cognitive impairment after transient ischemic attack F.G. van Rooij1, D.A.H.J. van Duijnhoven2, R.P.C. Kessels3, F.E. de Leeuw4, E.J. van Dijk5 Radboud University Nijmegen Medical Center Department of Neurology, Nijmegen, THE NETHERLANDS1, Radboud University Nijmegen Medical Center Department of Medical Psy-chology, Nijmegen, THE NETHERLANDS2, Radboud University Nijmegen Medical Center De-partment of Medical Psychology, Nijmegen, THE NETHERLANDS3, Radboud University Ni-jmegen Medical Center Department of Neurology, Nijmegen, THE NETHERLANDS4, Radboud University Nijmegen Medical Center Department of Neurology, Nijmegen, THE NETHERLANDS5 BACKGROUND: Although symptoms of a transient ischemic attack (TIA) by definition subside completely within 24 hours, patients often complain about cognitive disturbances after recovery of motor or language im-pairment. The aim of the study was to determine the prevalence and profile of cognitive impairment after TIA. METHODS: This cross-sectional cohort study consists of consecutive TIA-patients free from prior stroke or dementia, attending an outpatient TIA-service. Within 90 days after the TIA a comprehensive neu-ropsychological assessment was performed, covering the domains of attention, executive function, information processing speed, working memory and episodic memory. Possible depression was de-termined with the Hospital Anxiety and Depression Scale. A control group of healthy individuals matched for age, gender and level of education underwent the same neuropsychological assessment. Z-scores per cognitive domain were obtained by averaging z-scores of individual neuropsycholog-ical tests, which were based upon the mean of the control group. A z-score of -1,65 was considered cognitive impairment. Patients with incident brain infarct or carotid endarterectomy were excluded from further analysis. Student’s t-test and Chi-square test were used appropriately. RESULTS: One hundred ten TIA-patients (45 male, mean age 55.7 years (45-77), 26% low level of education) and 99 control subjects were included. The TIA-patients performed worse (p<0.001) on all cognitive domains except episodic memory. Impairment of working memory was present in 25% (p<0.001) of all TIA-patients, impairment of attention in 20% (p<0.001) and information processing speed impairment in 12% (p=0.001), com-pared to 5% in the control group (compatible with z-score = -1.65). CONCLUSION: After a TIA, one in four patients exhibits impairment on at least one cognitive domain, which is five times the prevalence in healthy controls, highlighting the need for specific attention to this problem during follow-up. 506 © 2013 S. Karger AG, Basel Scientific Programme 415 Behavioral disorders and post-stroke dementia Cognitive impairment after cerebral venous thrombosis: an observational study J.M. Bugnicourt1, E. Guegan-Massardier2, M. Roussel3, O. Martinaud4, C. Leclercq5, D. Wallon6, A. Triquenot-Bagan7, S. Canaple8, C. Lamy9, D. Hannequin10, O. Godefroy11 Amiens University Hospital, department of Neurology, Amiens, FRANCE1, Rouen University Hospital, department of Neurology, Rouen, FRANCE2, Amiens University Hospital, department of Neurology, Amiens, FRANCE3, Rouen University Hospital, department of Neurology, Rouen, FRANCE4, Amiens University Hospital, department of Neurology, Amiens, FRANCE5, Rouen University Hospital, department of Neurology, Rouen, FRANCE6, Rouen University Hospital, de-partment of Neurology, Rouen, FRANCE7, Amiens University Hospital, department of Neurology, Amiens, FRANCE8, Amiens University Hospital, department of Neurology, Amiens, FRANCE9, Amiens University Hospital, department of Neurology, Amiens, FRANCE11 Background The objective of this observational study of consecutive patients hospitalized for cerebral venous thrombosis (CVT) was to determine the prevalence of post-CVT cognitive impairment and identify factors associated with this condition. Methods Out of a total of 73 patients hospitalized for CVT, 52 were included in the study. At the last outpa-tient visit (mean ± SD time since CVT: 22 ± 13 months), a standardized, neuropsychological assess-ment was administered (n=44). Cognitive impairment was defined as significant impairment (with a cut-off at the 5th percentile) in at least two of the cognitive domains tested in the neuropsychologi-cal battery or severe aphasia or cognitive disorders with MMSE score </= 17 out of 30. Results Cognitive impairment was observed in 16 patients (31%; 95%CI: 18-43%): 4 with major disabil-ity precluding comprehensive assessment (3 with severe aphasia, 1 with MMSE </=17) and 12 with significant impairments in at least two cognitive domains. Determinants of long-term cogni-tive impairment were straight sinus involvement (OR: 22.4; 95%CI: 1.79-278.95; p=0.016) and the presence of parenchymal lesions on follow-up magnetic resonance imaging (OR: 7.8; 95%CI: 1.40- 43.04; p=0.019). The sole predictor of failure to return to full-time employment was cognitive im-pairment (OR: 21.0; 95%CI: 3.35-131.44; p=0.001). Conclusion Cognitive impairment persists in up to one third of cases of CVT. It is more frequent in patients with deep CVT and persistent parenchymal lesions and is associated with failure to return to full-time employment.
Karger_ESC London_2013
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