Correlation between cognitive impairment after stroke and compensatory degree of leptomeningeal collaterals and intravenous thrombolytic therapy

Abstract:

Objective To explore the correlation between post-stroke cognitive impairment and the degree of compensation of leptomeningeal collaterals and intravenous thrombolytic therapy in patients with acute ischemic stroke.Methods A total of 161 patients with acute anterior circulation cerebral infarction hospitalized in Shihezi People's Hospital from January 2019 to March 2021 were prospectively collected， and the demographic data at admission were obtained， including thrombolysis， gender， complications， etc. The cognitive function of patients was evaluated by Montreal cognitive assessment （MoCA） and mini mental state examination（MMSE）； the neurological deficit symptoms were obtained by the National Institute of Health Stroke Scale （NIHSS） score at admission； the ability of daily living of patients was evaluated by the score of Blessed behavior scale（BBS）； the regional leptomeningeal collateral score （rLMC） was used to evaluate the leptomeningeal collateral circulation. According to whether there was cognitive impairment 6 months after stroke， they were divided into cognitive impairment group and non-cognitive impairment group. Logistic multivariate regression method was used for statistical comparison to analyze the relationship between leptomeningeal collateral circulation， intravenous thrombolysis， complications， blood glucose， blood lipid and cognitive impairment after stroke.Results There were 161 patients with acute anterior circulation infarction， including 85 cases in cognitive impairment group and 76 cases in non-cognitive impairment group. Univariate analysis showed that there were significant differences in thrombolysis， rLMC， age and the score of BBS； multivariate binary logistic regression model showed that：①whether thrombolytic therapy had a statistically significant effect on the incidence of cognitive impairment， which was a protective factor；②age，rLMC， NIHSS score and BBS score had statistically significant effects on the incidence of cognitive impairment， and they were all risk factors；③there was no significant effect of gender and hypertension on the incidence of cognitive impairment.Conclusion Good collateral circulation and intravenous thrombolytic therapy can reduce the occurrence of post-stroke cognitive impairment in acute ischemic stroke. The older the age and the higher NIHSS score at admission， the greater the risk of post-stroke cognitive impairment in acute ischemic stroke.