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Cognitive Impairment After Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis
Syed Faraz Kazim1, Jonathan V Ogulnick2, Myranda B Robinson1
1Department of Neurosurgery, University of New Mexico (UNM) Hospital, Albuquerque, New Mexico, USA.
World Neurosurgery
|January 22, 2021
Summary
Post-intracerebral hemorrhage (ICH) cognitive impairment affects 46% of patients, with prevalence decreasing over time. Key affected domains include executive function and memory, with cortical atrophy and age as predictors.
Area of Science:
- Neurology
- Neuroscience
- Public Health
Background:
- Intracerebral hemorrhage (ICH) is a major cause of neurological disability.
- Cognitive impairment frequently complicates recovery after ICH.
- Understanding the prevalence and patterns of post-ICH cognitive impairment is crucial for patient management.
Purpose of the Study:
- To systematically review and meta-analyze the clinical literature on cognitive impairment following ICH.
- To determine the pooled prevalence of post-ICH cognitive impairment.
- To identify commonly affected cognitive domains and prognostic factors.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Comprehensive search of bibliographic databases up to July 31, 2020.
- Inclusion of 20 articles for qualitative review and 18 for quantitative meta-analysis (3270 patients).
Main Results:
- The overall prevalence of post-ICH cognitive impairment was 46% (CI, 35.9-55.9).
- Prevalence decreased longitudinally: 55% within 6 months to 35% after >6 months to 4 years.
- Nonverbal IQ, processing speed, executive function, memory, language, and visuoconstruction were most affected. Cortical atrophy, age, lobar ICH, and hemorrhage number predicted poor outcomes.
Conclusions:
- Post-ICH cognitive impairment is highly prevalent.
- Commonly affected cognitive domains and predictors have been identified.
- Future research should focus on larger prospective studies with standardized assessments for accurate prevalence and prognostic factor determination.
