Cognitive impairment before and after intracerebral haemorrhage: a systematic review

  • Claire DonnellanEmail author
  • David Werring
Review Article



There is increasing interest in understanding cognitive dysfunction before and after Intracerebral haemorrhage (ICH), given the higher prevalence of dementia reported (ranging from 5 to 44%) for this stroke type. Much of the evidence to date examining cognitive impairment associated with cerebrovascular disease has tended to focus more on ischaemic stroke. The aim of this review was to identify and quantify studies that focused on cognitive dysfunction pre and post ICH.


We conducted a systematic search using databases PubMed, Science Direct, Scopus and PsycINFO to identify studies that exclusively assessed cognitive function pre and post ICH. Studies were included in the review if used a measure of global cognition and/or a neuropsychological battery to assess cognitive function. Nineteen studies were deemed relevant for inclusion, where n = 8 studies examined cognitive impairment pre ICH and n = 11 post ICH.


Prevalence of cognitive impairment ranged between 9–29% for pre ICH and 14–88% for post ICH. Predictive factors identified for pre and post ICH were previous stroke, ICH volume and location and markers of cerebral amyloid angiopathy (CAA). Most common cognitive domains affected post ICH were information processing speed, executive function, memory, language and visuo-spatial abilities. Most common cognitive assessments tools were the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) for pre-existing cognitive impairment and the Mini-Mental State Examination for global cognition post ICH and the Trail Making Test where neuropsychological tests were used.


Cognitive impairment and dementia affected almost one-third of patients, whether assessed pre or post ICH.


Intracerebral haemorrhage Cognitive impairment Dementia Neuropsychological assessment Stroke 



The authors would like to thank Ms. Kate Brunskill, Deputy Librarian, Queen Square Library, Institute of Neurology and the National Hospital for Neurology and Neurosurgery for advising on the review search strategy and criteria.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10072_2019_4150_MOESM1_ESM.docx (19 kb)
ESM 1 (DOCX 19 kb)


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Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.School of Nursing and Midwifery, Faculty of Health SciencesUniversity of Dublin Trinity CollegeDublin 2Ireland
  2. 2.Stroke Research CentreUCL Institute of NeurologyLondonUK

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