Cognitive Impairment in First-Ever Right Hemispheric Stroke: A Cross-Sectional Study

Background: Cognitive dysfunction is a major, often under-recognized, determinant of long-term disability following stroke. While the right cerebral hemisphere is critical for non-verbal and integrative cognitive functions, dedicated studies evaluating the specific profile of cognitive impairment (CI) following first-ever right hemispheric stroke (RHS) in the Indian context are limited.

Objective: This cross-sectional study aimed to determine the prevalence and specific domains of cognitive impairment in patients with first-ever symptomatic RHS using a comprehensive neurocognitive assessment tool.

Methods: 64 patients with first ever symptomatic right hemispheric stroke were studied. Cognitive dysfunction was assessed with ACE-Malayalam and MMSE scores

Results:  The prevalence of cognitive dysfunction in right hemispheric stroke was 95.3% by ACE scoring and 68.7% by MMSE scoring. The cognitive domains most affected were visuospatial, attention and verbal fluency. The least affected was language.

Conclusion: Cognitive impairment is an almost universal consequence of first-ever RHS. The significant disparity between M-ACE and MMSE detection rates underscores the critical need to employ comprehensive, multi-domain cognitive tools like the ACE for routine screening. The distinct pattern of non-linguistic deficits, primarily in visuospatial function and attention/executive domains, has profound implications for targeted cognitive rehabilitation and long-term functional recovery planning for stroke survivors.