[Visual and spatial memory disorders: risk factors and recovery trajectory in the acute phase of ischemic stroke]

To assess the incidence of severe visual-spatial memory (VSM) disorders, the risk factors contributing to their development, and the changes observed during the acute phase of mild and moderate supratentorial ischemic stroke (IS).

A total of 140 patients in the acute phase of mild and moderate IS and 30 patients with chronic cerebral ischemia (CCI) were included in this study. All participants underwent clinical neurological, neuropsychological, and neuroimaging assessments. The patients were categorized into three groups: Group 1 comprised 54 patients with IS localized in the posterior medial and posterolateral regions; Group 2 included 86 patients with IS lesions of other localization; and Group 3 consisted of 30 patients with CCI. Neuropsychological evaluations were conducted using the Addenbrooke's Cognitive Examination III (ACE-III), Corsi Block-Tapping Task (CBTT), and Geriatric Complex Figure (GCF), which included GCF Copy and GCF Recall subtests. Initial testing occurred on days 4-5 of hospitalization (T1), with follow-up assessments performed after 14-16 days (T2) for patients with IS.

Severe VSM disorders were detected in 20% of patients diagnosed with IS. In Group 1, the prevalence of such disorders was significantly higher (38.9%) than in Group 2 (8.1%; p<0.001) and Group 3 (10.0%; p=0.005). Analysis during the T1-T2 interval demonstrated a notable improvement in VSM, particularly in GCF Recall, in both Group 1 and Group 2. However, at T2, the GCF Recall scores in Group 1 remained comparatively lower than those in Group 2 (p=0.004). Furthermore, the rate of recovery from VSM in Group 1 was slower than that observed in Group 2 (p<0.001).

The study concludes that severe VSM disorders occur in 20% of patients experiencing mild and moderate acute IS, with a higher incidence associated with lesions localized in the posterior regions of the brain. The recovery trajectory from VSM during the acute phase of IS is notably slower in patients with a posterior-medial ischemic focus than in those with a posterolateral ischemic focus.