International Journal of Neurology and Neurosurgery

Background: Stroke is a leading cause of adult disability and mortality worldwide. Beyond motor and sensory deficits, cognitive dysfunction after stroke substantially affects independence and rehabilitation. Timely detection of post-stroke cognitive impairment (PSCI) allows early intervention. The present study assessed neurocognitive functions in post-acute stroke patients who underwent endovascular or decompressive surgical intervention and compared them with healthy controls using the Addenbrooke’s Cognitive Examination III (ACE-III). Methods: This hospital-based observational case–control study included 40 consecutive patients (18–80 years) with first-ever acute stroke (< 7 days) admitted to the Neurosciences Department, Santokba Durlabhji Memorial Hospital, Jaipur, and 40 age and sex-matched healthy controls. Cases underwent endovascular thrombectomy, aneurysm coiling, clipping, or decompressive craniectomy. Cognitive performance was evaluated at 3 and 6 months using the Hindi-adapted ACEIII assessing five domains attention/orientation, memory, fluency, language, and visuospatial abilities. Statistical analysis used SPSS v22; p < 0.05 was considered significant. Results: Mean patient age was 58.6 ± 11.2 years; 60%were male. Ischemic stroke comprised 72.5%of cases and haemorrhagic 27.5%. Hypertension (42.5%) and diabetes (27.5%) were the most frequent comorbidities. At 3 months, 72.5%of patients demonstrated cognitive impairment versus 62.5%at 6 months. Total ACE-III scores improved from 60.9 ± 10.9 to 74.5 ± 10.7 (p < 0.001). Memory and language domains were most affected initially. Cognitive outcomes did not differ significantly by stroke subtype.