Browsing by Author "Moliis, Henrik"

Background and purpose: Cognitive impairment is a common and well-known consequence of supratentorial infarct, but its prevalence and severity after infratentorial infarct is unclear. We compared the frequency and prognostic value of domain-specific cognitive deficits after supratentorial and infratentorial infarct. Methods: In a consecutive cohort of first-ever stroke patients (N=244) admitted to Helsinki University Hospital, 37 patients had an infratentorial infarct. Patients were assessed by a neuropsychologist 3 months post-stroke in 9 cognitive domains, and functional disability was assessed at 15 months. Frequencies of cognitive deficits were compared using the Pearson chi-square test. The association between cognitive deficits and functional disability at the 15-month follow-up was analysed using logistic regression. Results: There was no significant difference between the frequency of cognitive deficits in patients with infratentorial vs supratentorial infarct. Altogether 73% of patients with infratentorial infarct and 82.1% of patients with supratentorial infarct had impairment in at least one cognitive domain, and 42.3% in the infratentorial group and 47.3% in the supratentorial group had deficits in 3 or more cognitive domains. In the infratentorial group, only visuoconstructional and spatial functions showed at least a convincing trend of association with functional disability at 15 months (OR 9.0, 95%CI 1.3-62.5, p=0.027). In the supratentorial group, both executive functions and attention (OR 2,9, 95%CI 1.5-5.8, p=0.002) and visuoconstructional and spatial functions (OR 2.9, 95%CI 1.5-5.7, p=0.001) showed this association. Conclusion: Cognitive deficits are as common in infratentorial as in supratentorial infarct, and it is important to recognize them to meet the needs of rehabilitation.