The objective of this study is to examine the prognosis of acute
cognitive disorders post-stroke, and to evaluate which clinical factors
predict domain-specific cognitive recovery. We followed the course of
cognitive functioning in 111 stroke patients and 77 healthy controls by
administering two neuropsychological examinations with a 6 to 10 month
interval (mean interval, 7.5 ± 1.3 months). The baseline
examination was administered within three weeks post-stroke (mean
interval, 7.9 ± 4.2 days). To examine determinants of
domain-specific cognitive recovery, we recorded vascular risk factors,
clinical variables, and lesion characteristics. Recovery in visual
perception/construction (83%) and visual memory (78%) was the most
common. An acute cognitive disorder predicted a long-term disorder in the
same domain (all p < .05), except for visual
perception/construction. Factors associated with poor cognitive
recovery were age (all p < .01), preexistent verbal ability
(all p < .005), lesion locations involving the temporal (all
p < .05), frontal (p < .05) and occipital lobe
(all p < .05), lesion volume (p ≤ .001), and
diabetes mellitus (p < .01). An early neuropsychological
examination provides valuable information on long-term cognitive
performance. The prognosis of higher-level visual disorders is the most
favorable. Cognitive recovery is associated with age, preexistent ability,
lesion volume, lesion location, and diabetes mellitus. (JINS,
2005, 11, 795–806.)