Post-Stroke Cognitive Impairment – Phenomenology and Prognostic Factors

Abstract

Stroke patients are at higher risk of developing cognitive impairment. Cognitive dysfunctions, especially progressive ones, worsen stroke prognosis and outcome. A longitudinal follow-up of cognitive disorders, however, is rendered difficult by their heterogeneity and the lack of definitions generally agreed upon. Stroke is a major cause of cognitive deficit. The identification of risk factors, clinical determinants and laboratory markers of post-stroke cognitive deficit may help detect patients at increased risk of cognitive deterioration, and prevent or delay the occurrence of poststroke cognitive impairments. Though inflammatory processes have been implicated in the pathogenesis of stroke, their role in the complex pathophysiological mechanisms of post-stroke cognitive impairment is not completely understood. Evidence suggests that elevated serum Creactive protein is associated with both the increased risk of stroke and post-stroke cognitive deficit. The hypothesis of a possible relationship between markers of systemic inflammation and cognitive dysfunctions raises the question of how rational the option of applying non-steroidal antiinflammatory drugs in a proper therapeutic window will be, especially during the acute phase of stroke, to prevent cognitive decline and dementia.

Cognitive state following mild stroke: A matter of hippocampal mean diffusivity

“…Following stroke, the frequency of dementia is four to six times higher than the frequency of dementia in age matched subjects without a history of stroke (Erkinjuntti, 2007;Danovska et al, 2012). Despite recent advances in the study of cognition, much remains unknown regarding the pathogenesis and progression of cognitive impairments in stroke patients (Pendlebury and Rothwell, 2009;Farr and Wegener, 2010;Gottesman and Hillis, 2010).…”

Cognitive Function Profile of Post-Stroke Patients

“…13 The frequency of cognitive impairment in the acute phase of stroke is estimated to be more than 70% but, in the first week and a few months after stroke, recovery of cognitive function occurs through the re-canalization followed by reperfusion or brain plasticity. 14 The process of functional recovery in poststroke patients can still continue to occur up to a certain extent, especially in the first 3-6 months after a stroke or is in the sub acute phase of stroke rehabilitation. 5 According to the results, most of the patients who come for rehabilitation were in the sub acute phase.…”

Transcranial direct current stimulation (tDCS) in patients with aphasia after cerebral stroke

“…Zmiany te mogą być również mało adaptacyjne [10,11]. Zmiany w zakresie funkcjonowania tkanki nerwowej mózgu mają przełożenie na zwiększony wysiłek poznawczy [12,13,14]. Badania kliniczne dowodzą, że behawioralne zaburzenia poudarowe stabilizują się powoli, a niekiedy nigdy nie zostają ustabilizowane [7,[14][15][16][17][18].…”