how do you know when true cognition is gone?

Hello and welcome to e health forum.

I am very sorry about your loss.

It seems that you want to know if your partner was dejected or anger issues with you during his last days, and it was due to such reasons that he wanted to hit you.

I would like to assure you that it is not such a case of anger.

Patients with severe stroke due to end stage leukaemia have severe confusion usually due to associated medical issues including delirium and acute psychosis. Hence they show features of aggression to anyone around them including the treating physicians or nursing staff. Though they speak out or appear in their own self, they do not actually mean what they say or do.

With respect to the actual status of normal cognition in stroke patients , it varies with the severity of stroke and the area of the brain affected. In a massive stroke which affects large areas of the cerebral cortex and thalamus, it will be lost almost immediately.

In case of mild strokes, only the internal capsule or the basal ganglia is affected, the most affected are the motor movements and cognition is usually intact.

But eventually, presence or absence of proper cognition can be determined only by clinical assessment and a set of questionaire like Mini Mental Status Examination, etc.

I hope this helps.