One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective: To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods: Literature 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. Conclusion: Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others.
CITATION STYLE
Moulin, S., & Leys, D. (2017, February 1). Stroke occurring in patients with cognitive impairment or dementia. Arquivos de Neuro-Psiquiatria. Associacao Arquivos de Neuro-Psiquiatria. https://doi.org/10.1590/0004-282X20160187
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