Anosognosia in acute stroke and functional recovery after stroke

Abstract

The aim of this study was to evaluate anosognosia in acute stroke phase in order to type of stroke (ischemia, hemorrhage) and stroke localization as well as post-stroke patients recovery. Subjects and methods: In this prospective analysis were included 191 patients (96 males and 95 females) with first-ever stroke who were treated at the Department of neurology of the University Clinical Center in Tuzla. All patients were tested to anosognosia presence in acute stroke phase according to the modified Bisiach scale (7), while the level of disability was assessed using the Rankin scale (8) and level of functioning in daily activities using the Barthel index (9). Re-testing was done in week five post-stroke. Results: The average age of patients was 66.41 (mean age 10.21). Ischemic stroke had 168 patients (88%) while 23 (12%) the hemorrhagic one. The lesions localized to the right hemisphere were in 111 (58.11%) patients as well as in 80 (41.89%) patients with lesions localized to the left hemisphere. Anosognosia with no statistical significance was verified in 28% of patients in acute stroke phase, more often caused by lesions to the right hemisphere. Otherwise, significantly more frequent anosognosia was present in patients with hemorrhagic stroke mostly caused by massive lesions localized to the right hemisphere. Conclusion: Presence of anosognosia in patients with stroke vitally influenced patient’s functional status in re-testing phase just as well as in the acute stroke phase.