[Cognitive deterioration following intracranial haemorrhage: predominantly dependent on cognitive health before the...

Strokes are associated with an increased risk of cognitive dysfunction and dementia, but little is known about the effect of intracranial haemorrhage on cognitive deterioration. The paper discussed here evaluated 167 patients with an intracranial haemorrhage and with several mini-mental state examination (MMSE) measurements over time, starting 6 months after the index event. Only those risk factors already present before the haemorrhage, such as pre-existing cognitive dysfunction and cortical atrophy on MRI, were associated with more severe cognitive deterioration. This suggests that cognitive deterioration is independent of intracranial haemorrhage; however, there are several caveats. The lack of a control group and lack of cognitive data before the haemorrhage limit the number of conclusions that can be drawn. Whether it has an isolated or a neurodegenerative effect on cognition or not, a stroke is always best prevented. As strokes and dementia have considerable overlap in risk factors, prevention is the key.