Post-stroke and vascular depression: a critical review.

Increasing interest in depression within acute and chronic cerebrovascular pathology is justified for its clinical relevance. The scientific community strongly recommends taking into account its identification and management in efforts to reduce disability, the caregiver's burden and the social-economic impact of cerebrovascular disease. Different approaches observed in the literature review make it difficult to generalize about the evidence concerning crucial clinical issues such as diagnostic criteria, impact on functional improvement, selection or timing of depression treatment. Furthermore, the relationship between cerebral lesion location and depression is not agreed, because both hemispheres are reported as prevailing in published case series. On the other hand, vascular depression is commonly related to diffuse subcortical involvement. Because of its clinical and social impact, a definition of the unclear features of depression within acute and chronic cerebrovascular disease is urgently needed.