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Clinical Manifestations
Foksouna Sakadi1, Nderbe Melom Christelle2, Allaissem Doumdongar3
1Department of Neurology, Reference Hospital, Ndjamena, NDdjamena, Ndjamena, Chad.
Insights
Cognitive impairment frequently complicates stroke, increasing patient dependence. This study highlights the need for better understanding and management of these cognitive issues in stroke survivors.
Area of Science:
- Neurology
- Public Health
- Cognitive Science
Background:
- Stroke presents a significant global health challenge with substantial socio-economic impacts.
- Cognitive complications following stroke remain understudied in many regions, including Chad.
- Understanding these complications is crucial for effective patient management and care.
Purpose of the Study:
- To describe the prevalence and characteristics of cognitive impairment in stroke patients in Chad.
- To provide data that can inform improved management strategies for stroke survivors.
Main Methods:
- A cross-sectional, descriptive, multicenter study was conducted over 8 months in three referral hospitals in Ndjamena.
- 24 stroke patients diagnosed with cognitive impairment (VASCOG criteria) were assessed using various tools including MMSE, Albert test, Rey figure, ISDC, GADS, and Barthel scale.
- Data collected included sociodemographic, anamnestic, clinical, and paraclinical variables.
Main Results:
- 18.18% of the enrolled stroke patients exhibited cognitive impairment.
- Common issues included memory problems (100%), motor deficits (20%), and language disorders (12%).
- Significant findings included perceptual neglect (16%), total dependence in daily activities (41.7%), and moderate depression (41%).
Conclusions:
- Cognitive impairment is a common and significant complication of stroke, directly contributing to increased patient dependence.
- Further research with comprehensive neuropsychological assessments and neuroimaging is recommended to better understand stroke-related cognitive deficits.
Background:
Stroke is a serious public health problem and neurological condition with a huge socio-economic burden related to its complications. However, cognitive complications of stroke have not been studied in Chad. Therefore, this study aimed at describing cognitive impairment in patients followed up for stroke with the goal of improving management.
Method:
This was a cross-sectional descriptive multicenter study conducted over an 8-month period (30th November to 31st July 2023). The study took place in three referral hospitals in Ndjamena: CHURN, CHU-R and HATC. All patients admitted for stroke and diagnosed with cognitive impairment according to VASCOG criteria were included. The variables studied were: sociodemographic, anamnestic, clinical and paraclinical. The MMSE, the Albert test, the Rey figure, the ISDC test were used to assess cognitive impairment while the Goldberg Anxiety and Depression (GADS) scale assessed level of anxiety/depression and the Barthel scale provided information on participant's activities of daily living.
Result:
During the study period, we enrolled 24 patients (58.3% males) and 18.18% of total sample had cognitive impairment. The mean age of the patients was 58.17 ± 11.99 years, (range: 48 - 89). All our patients had consulted for memory problems and on examination, 20 (%) had motor deficits and 12 (%) had language disorders. The MMSE ranged from [0-17] in 14 patients (%) to [18-23] in 6 patients (%). The Albert test revealed perceptual neglect in 16 (%) patients. The Barthel scale found 41.7% of patients to be totally dependent, and the GADS revealed moderate depression in 41% of patients.
Conclusion:
This study showed that cognitive impairment is frequently associated with stroke and aggravates patient dependence. There is need for more in-depth with a more comprehensive neuropsychological batteries and imaging studies.
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