• Arq Neuropsiquiatr · Feb 2017

    Review

    Stroke occurring in patients with cognitive impairment or dementia.

    • Solène Moulin and Didier Leys.
    • Université de Lille. INSERM U 1171, Troubles cognitifs dégénératifs et vasculaires. CHU de Lille, Service de Neurologie, Lille, France.
    • Arq Neuropsiquiatr. 2017 Feb 1; 75 (2): 117-121.

    ObjectiveTo determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management.MethodsLiterature search.Results(i) A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii) Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii) Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv) Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others.ConclusionPatients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others.

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