Transient Cognitive Impairment in TIA and Minor Stroke

• Published in: Stroke (1970) 2011-11, Vol.42 (11), p.3116-3121
• Main Authors: PENDLEBURY, Sarah T, WADLING, Sarah, SILVER, Louise E, MEHTA, Ziyah, ROTHWELL, Peter M
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - etiology; Cognitive Dysfunction - psychology; Cohort Studies; Female; Follow-Up Studies; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Ischemic Attack, Transient - complications; Ischemic Attack, Transient - diagnosis; Ischemic Attack, Transient - psychology; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Population Surveillance - methods; Prospective Studies; Stroke - complications; Stroke - diagnosis; Stroke - psychology; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/strokeaha.111.621490

Acute cognitive impairment and delirium occur after major stroke and are associated with poor cognitive outcome. We conducted a population-based study to determine whether transient cognitive impairment (TCI) is seen acutely after cerebral transient ischemic attack (TIA) or minor stroke, and whether it predicts long-term cognitive decline. Mini-mental-state examination was performed in consecutive testable patients with TIA or minor stroke (National Institutes of Health Stroke Scale ≤3) seen acutely (1-7 days) in the Oxford Vascular Study (2002-2005) versus after 7 days, and in referrals seen acutely who had a subsequent noncerebrovascular diagnosis. We defined TCI as a baseline Mini-mental-state examination score ≥2 points below the 1-month follow-up score, and identified cognitive impairment (Montreal Cognitive Assessment [MoCA]