{"id":292,"date":"2013-03-06T08:43:51","date_gmt":"2013-03-06T08:43:51","guid":{"rendered":"https:\/\/blogs.bmj.com\/jnnp\/?p=292"},"modified":"2013-03-18T12:02:59","modified_gmt":"2013-03-18T12:02:59","slug":"the-first-week","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/jnnp\/2013\/03\/06\/the-first-week\/","title":{"rendered":"The First Week"},"content":{"rendered":"<p><span style=\"color: #008000;\"><strong>Dr Susanna Park from the Institute of Neurology, UK critically considers Stroke and the First Week<\/strong><\/span><\/p>\n<p>The focus of the March issue of JNNP is stroke, highlighting a range of research assessing risk factors, prognosis, treatment and management.<\/p>\n<p>In this timely issue, Kauranen and colleagues<sup>1<\/sup> present a study which emphasises the importance of cognitive function in the early stages after a stroke as a predictor of long term outcomes. In the study, 140 patients who experienced a first ever ischaemic stroke underwent a neurocognitive evaluation within the first week post-stroke. Before their stroke, all of the patients were engaged in full time employment. Six months later, the main predictor for a return to work was the number of cognitive deficits that were present in the first week.<\/p>\n<p>Importantly, each additional cognitive deficit present in the first week doubled the likelihood of a patient being unable to return to employment at follow-up. This study stresses the role of cognition as an important predictor of long term outcomes post-stroke<sup>2<\/sup>, with previous studies indicating that cognitive status is also predictive of long-term functional status<sup>3<\/sup> and quality of life<sup>4<\/sup>.<\/p>\n<p>In the same issue of JNNP, El Hachioui and colleagues<sup>5<\/sup> identified that the degree of aphasia one year following a stroke could be predicted within the first week by a combination of factors including phonology scores and stroke severity indices. These studies highlight the first week following stroke as a critical window not only for prognosis but also for rehabilitation and recovery.\u00a0 Not only are early assessments of cognition and language invaluable for predicting long-term prognosis for stroke patients, but early interventions may be able to intervene in this time period to boost functional recovery and rehabilitative outcomes long-term.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_248\" aria-describedby=\"caption-attachment-248\" style=\"width: 204px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/blogs.bmj.com\/jnnp\/files\/2012\/12\/Michael-Lynagh-and-Dr-Rob-Henderson-Dodging-a-cannonball.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-248\" alt=\"Recovery post-stroke.  Wallaby great Michael Lynagh and his neurologist Dr Rob Henderson - discuss Noddies miraculous recovery post-stroke\" src=\"https:\/\/blogs.bmj.com\/jnnp\/files\/2012\/12\/Michael-Lynagh-and-Dr-Rob-Henderson-Dodging-a-cannonball-204x300.jpg\" width=\"204\" height=\"300\" srcset=\"https:\/\/blogs.bmj.com\/jnnp\/files\/2012\/12\/Michael-Lynagh-and-Dr-Rob-Henderson-Dodging-a-cannonball-204x300.jpg 204w, https:\/\/blogs.bmj.com\/jnnp\/files\/2012\/12\/Michael-Lynagh-and-Dr-Rob-Henderson-Dodging-a-cannonball.jpg 306w\" sizes=\"auto, (max-width: 204px) 100vw, 204px\" \/><\/a><figcaption id=\"caption-attachment-248\" class=\"wp-caption-text\"><strong><span style=\"color: #008000;\">Recovery post-stroke.<\/span><\/strong><br \/><strong><span style=\"color: #008000;\">Wallaby great Michael Lynagh and his neurologist Dr Rob Henderson &#8211; discuss Noddy&#8217;s miraculous recovery post-stroke<\/span><\/strong><\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p><b>References<\/b><\/p>\n<p>1. Kauranen T, Turunen K, Laari S, Mustanoja S, Baumann P, Poutiainen E (2013) The severity of cognitive deficits predicts return to work after a first ever ischaemic stroke. <i>JNNP<\/i> 84: 316-321.<\/p>\n<p>2. Arauz A. (2013) Return to work after stroke: the role of cognitive deficits.<i> JNNP<\/i> 84: 240.<\/p>\n<p>3. Wagle J, Farner L, Flekk\u1d13y K, Bruun Wyller T, Sandvik L, Fure B, Stensr\u1d13d B, Engedal K (2011). Early post-stroke cognition in stroke rehabilitation patients predicts functional outcome at 13 months.\u00a0 <i>Dement Geriatr Cogn Disord <\/i>31: 379-387.<\/p>\n<p>4. Nys GM, van\u00a0 Zandvoort MJ, van der Worp HB, de Haan EH, de Kort\u00a0 PL, Jansen BP, Kappelle LJ. (2006). Early cognitive impairment predicts long-term depressive symptoms and quality of life after stroke.<i> J Neurol Sci<\/i> 247: 149-56<\/p>\n<p>5. El-Hachioui H, Lingsma HF, van de Sandt-Koenderman MWME, Dippel DWJ, Koudstaal PJ, Visch-Brink EG. (2013) Long-term prognosis of aphasia after stroke. <i>\u00a0JNNP<\/i> 84: 310-315.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dr Susanna Park from the Institute of Neurology, UK critically considers Stroke and the First Week The focus of the March issue of JNNP is stroke, highlighting a range of research assessing risk factors, prognosis, treatment and management. In this timely issue, Kauranen and colleagues1 present a study which emphasises the importance of cognitive function [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/jnnp\/2013\/03\/06\/the-first-week\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-292","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The First Week - JNNP blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/jnnp\/2013\/03\/06\/the-first-week\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The First Week - JNNP blog\" \/>\n<meta property=\"og:description\" content=\"Dr Susanna Park from the Institute of Neurology, UK critically considers Stroke and the First Week The focus of the March issue of JNNP is stroke, highlighting a range of research assessing risk factors, prognosis, treatment and management. 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