Development of a Delayed Cerebral Infarction Load Scoring System (DCI Score)

Area of Science:

• Neurology
• Neuroscience
• Clinical Medicine

Background:

• Delayed cerebral infarction (DCI) is a known complication following aneurysmal subarachnoid hemorrhage (SAH).
• The precise impact of DCI load on long-term cognitive outcomes after SAH remains incompletely understood.
• Existing clinical classifications for brain hemorrhages and cerebral infarction lack a specific metric for DCI burden.

Purpose of the Study:

• To develop and validate a quantitative scoring system for assessing the load of delayed cerebral infarction (DCI) after aneurysmal subarachnoid hemorrhage (SAH).
• To investigate the correlation between the devised DCI Score and various cognitive function tests.

Main Methods:

• A comprehensive literature review was performed on existing classification systems for brain hemorrhages and cerebral infarction.
• A novel Delayed Cerebral Infarction Load Scoring System (DCI Score) was developed based on the review.
• The DCI Score was correlated with results from cognitive assessments including the Symbol Digit Modalities Test, Color Trail Test, Hong Kong List Learning Test, and verbal/visual digit spans.

Main Results:

• The DCI Score demonstrated significant negative correlations with multiple cognitive tests.
• Specifically, the DCI Score correlated with Symbol Digit Modalities Test (r=-0.334, p=0.032), Color Trail Test (r=-0.310, p=0.032), Hong Kong List Learning Test (r=-0.318, p=0.036), Verbal Digit Span Forward (r=-0.382, p=0.017), and Visual Digit Span Backward (r=-0.425, p=0.012).
• These findings indicate that a higher DCI load is associated with poorer performance in memory and executive function domains.

Conclusions:

• Increased DCI load significantly impairs memory and executive functions in patients following SAH.
• The developed DCI Score serves as a valuable tool for the clinical quantification of DCI burden.
• The DCI Score holds potential for enhancing clinical research and patient management in SAH.