The neuropsychology needs of a hyper-acute stroke unit

JOURNAL OF THE NEUROLOGICAL SCIENCES

卷:423

Article

Martin, Naomi H.¹  Cornish, Bronwyn²  Browning, Simone^3,4  Simister, Robert^3,4  Werring, David J.^3,4  Cipolotti, Lisa^1,3,4  Chan, Edgar^1,3,4 

[1] Natl Hosp Neurol & Neurosurg, Dept Neuropsychol, Queen Sq,Box 37, London WC1N 3BG, England

[2] Natl Hosp Neurol & Neurosurg, Occupat Therapy Dept, Queen Sq, London, England

[3] Univ Coll London Hosp NHS Trust, Comprehens Stroke Serv, London, England

[4] Univ Coll London Hosp NHS Trust, UCL Queen Sq Inst Neurol, Dept Brain Repair & Rehabil, Ctr Stroke Res, Russell Sq House, London, England

关键词: Stroke;    Hyperacute;    Neuropsychology;    Cognition;    Mood;   

DOI  :  10.1016/j.jns.2021.117382

来源: Elsevier

【 摘 要 】

Background and aim: Guidelines recommend routine assessment and management of mood and cognition after stroke, but little is known about the value or feasibility of providing neuropsychology input during the hyperacute period. We aimed to identify and describe the extent and nature of neuropsychological needs and to investigate the feasibility of providing direct neuropsychology input within a hyper-acute setting. Methods: Over a 7-month period, Multidisciplinary Team (MDT) members of a central London Hyper-Acute Stroke Unit (HASU) identified stroke patients who they believed would benefit from neuropsychology input, and categorised the nature of neuropsychology intervention required. We examined the demographic and clinical characteristics of the patients identified and the type of intervention required. Results: 23% of patients (101/448) were identified as requiring neuropsychology input. Patients deemed to require input were younger, more likely to be male and more functionally disabled than those not requiring input. Cognitive assessment was the main identified need (93%) followed by mood (29%) and family support (9%). 30% of patients required two types of intervention. During a pilot of neuropsychology provision, 17 patients were seen; 15 completed a full cognitive assessment. All patients assessed presented with cognitive impairment despite three being deemed cognitively intact (> standardised cut-off) using a cognitive screening tool. Conclusion: We showed that direct neuropsychology input on a HASU is necessary for complex and varied interventions involving cognition, mood and family support. Furthermore, input is feasible and useful in detecting cognitive impairment not revealed by screening instruments.

【 授权许可】

Free