The Degree of Cognitive Impairment in Patients with Lacunar Stroke Depending on the Hemispheric Lateralization of the Lesion

Bekhzod Abdullaev

doi:10.11648/j.ajpn.20170505.12

Abstract

The most susceptible to vascular dementia persons with lesions of small cerebral vessels. This variant of the pathology is characterized by subacute course and pathologic basis is diffuse changes in the white matter of the cerebral hemispheres and lacunar infarctions, in most cases - multiple. That is why the appearance of lacunar infarcts associated with step-progression of the disease. However, not in all cases, there is a significant cognitive defect even in a lacunary condition. The aim of the study was to identify cognitive impairment in patients with lacunar stroke, depending on hemispheric lateralization of the lesion. We observed and surveyed 70 patients (mean age 60.2 + 6.3) suffered the lacunar stroke with hemispheric lateralization of the lesion. In this work, we used the Mini-Mental State Examination (MMSE) and Montreal scale assessment of cognitive functions (MoCA), the Saint Louis University Mental Status Examination (SLUMS), which have been developed as a tool to identify and assess the severity of cognitive functions in general practice. Comparative analysis of cognitive impairment on the stage of the disease in the control group showed that in general, patients suffered lacunar stroke level of violations was significantly higher than the control group (p≤0.01). Cognitive function in right lacunar stroke corresponded moderate cognitive impairment and the restoration of the neurological defect in the dynamics were less expressed and are not complete. Cognitive impairment in the left hemisphere lacunar stroke had a mild degree of cognitive impairment and restoration of disturbed functions is progressing at a faster pace, about what speak reliable indicators of the late recovery period (p≤0.05). The differences in cognitive disorders at different focus lateralization underlie the clinical features and determine the nature and pace of the recovery of lost functions. Mild cognitive impairment in the left-hand lacunar stroke is a favorable prognostic factor in terms of the recovery of lost functions.

Highlights

In recent decades, the rate of cerebrovascular disease is steadily increasing (30%)
As can be seen from table 1, the number of men prevailed over women in two groups, respectively
We have tried to investigate cognitive impairment in stroke patients according to age, sex, education, stroke risk factors, localization and hemispheric lateralization of the lesion

Summary

Introduction

The rate of cerebrovascular disease is steadily increasing (30%). Vascular diseases are the cause of disability and the social level of life. According to WHO, mortality from brain stroke takes the second place (21.4%) in overall mortality cases. A primary stroke occurs in 15 million. In the U.S, the death rate from stroke is 750,000, which is 40 per 100,000 of the population in Russia is 175 people per 100,000 population. Ischemic stroke occurs 5-6 times more frequently and is 80-85% and hemorrhagic 15-

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