Higher cortical function deficits among acute stroke patients: The stroke data bank experience

Michael Hoffmann, Ralph L Sacco, Jay P. Mohr, Thomas K. Tatemichi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives. Both the number and type of higher cortical function deficits (HCFD) in acute stroke patients are important diagnostically and for gauging the extent of neurological deficits. Methods. The Stroke Data Bank (SDB) provided a large prospective data base for such evaluation. Thirty-one different HCFDs, each defined in the SDB manual, were considered. Results. Of 1,805 patients in the SDB, 641 instances of HCFD in 422 patients were recorded in alert patients at initial examination (within the first 7 to 10 days of ictus). Aphasia (41%) was the most commonly found HCFD, followed by neglect syndrome (27.2%), apraxia (11.7%), and anosognosia (11.1%). Agnosia (3.9%), alexia (3.3%), and aprosodia (1.5%) were less frequently found HCFDs. Cardioembolic infarct was most likely to have associated HCFDs (66%), and lacunar infarction was least likely to be accompanied by HCFDs (6%), with infarction caused by large artery thrombosis (50%) and infarct of undetermined cause (47%) having similar frequencies. The co-occurrence of sensory and motor deficits among the eight major subgroups of HCFD showed that neglect syndrome, apraxia, and anosognosia were most likely to be associated with long tract signs, whereas alexia, aprosodia, and agnosia invariably were not associated with sensorimotor impairment. Approximately half of aphasic patients had associated sensorimotor impairment. Conclusion. Our findings show that higher cortical function deficits are prevalent in the acute phase of stroke, particularly aphasia and neglect syndromes. They are more often associated with nonlacunar stroke and some are less likely to be associated with any sensorimotor deficits.

Original languageEnglish
Pages (from-to)114-120
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume6
Issue number3
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

Fingerprint

Agnosia
Stroke
Databases
Speech Disorders
Apraxias
Dyslexia
Aphasia
Lacunar Stroke
Infarction
Thrombosis
Arteries

Keywords

  • Cognitive disorder
  • Data bank
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

Cite this

Higher cortical function deficits among acute stroke patients : The stroke data bank experience. / Hoffmann, Michael; Sacco, Ralph L; Mohr, Jay P.; Tatemichi, Thomas K.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 6, No. 3, 01.01.1997, p. 114-120.

Research output: Contribution to journalArticle

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abstract = "Objectives. Both the number and type of higher cortical function deficits (HCFD) in acute stroke patients are important diagnostically and for gauging the extent of neurological deficits. Methods. The Stroke Data Bank (SDB) provided a large prospective data base for such evaluation. Thirty-one different HCFDs, each defined in the SDB manual, were considered. Results. Of 1,805 patients in the SDB, 641 instances of HCFD in 422 patients were recorded in alert patients at initial examination (within the first 7 to 10 days of ictus). Aphasia (41{\%}) was the most commonly found HCFD, followed by neglect syndrome (27.2{\%}), apraxia (11.7{\%}), and anosognosia (11.1{\%}). Agnosia (3.9{\%}), alexia (3.3{\%}), and aprosodia (1.5{\%}) were less frequently found HCFDs. Cardioembolic infarct was most likely to have associated HCFDs (66{\%}), and lacunar infarction was least likely to be accompanied by HCFDs (6{\%}), with infarction caused by large artery thrombosis (50{\%}) and infarct of undetermined cause (47{\%}) having similar frequencies. The co-occurrence of sensory and motor deficits among the eight major subgroups of HCFD showed that neglect syndrome, apraxia, and anosognosia were most likely to be associated with long tract signs, whereas alexia, aprosodia, and agnosia invariably were not associated with sensorimotor impairment. Approximately half of aphasic patients had associated sensorimotor impairment. Conclusion. Our findings show that higher cortical function deficits are prevalent in the acute phase of stroke, particularly aphasia and neglect syndromes. They are more often associated with nonlacunar stroke and some are less likely to be associated with any sensorimotor deficits.",
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