Long-term cognitive impairment associated with caudate stroke

Background and Purpose Neuropsychiatric findings were examined in 91 patients with acute focal subcortical lesions to determine whether cognitive outcome would differ depending on whether the head of the caudate or other subcortical structures were injured. Methods Patients were evaluated using the Mini-Mental State Examination (MMSE), Hamilton Rating Scale for Depression, and modified Present State Examination. Patients were reexamined at short-term (3 to 6 months) or long-term (1 to 2 years) follow-up. Results There were no significant intergroup differences in the MMSE scores at the initial evaluation or at short-term follow-up. At long-term follow-up, however, patients with either right or left caudate lesions had significantly lower MMSE scores than patients with other subcortical lesions. Conclusions A significant number of patients with caudate infarction deteriorate in their intellectual function between 1 and 2 years after stroke. This phenomenon could be mediated through disruption of cortical projections to the caudate.