Verdelho Ana, Wardlaw Joanna, Pavlovic Aleksandra, Pantoni Leonardo, Godefroy Olivier, Duering Marco, Charidimou Andreas, Chabriat Hugues, Biessels Geert Jan
Department of Neurosciences and Mental Health, CHLN-Hospital de Santa Maria, Instituto de Medicina Molecular - IMM e Instituto de Saúde Ambiental -ISAMB, Faculdade de Medicina, University of Lisbon, Lisbon, Portugal.
Centre for Clinical Brain Sciences, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Eur Stroke J. 2021 Mar;6(1):5-17. doi: 10.1177/23969873211000258. Epub 2021 Feb 28.
Many daily-life clinical decisions in patients with cerebrovascular disease and cognitive impairment are complex. Evidence-based information sustaining these decisions is frequently lacking. The aim of this paper is to propose a practical clinical approach to cognitive impairments in patients with known cerebrovascular disease.
The document was produced by the Dementia Committee of the European Stroke Organisation (ESO), based on evidence from the literature where available and on the clinical experience of the Committee members. This paper was endorsed by the ESO.
Many patients with stroke or other cerebrovascular disease have cognitive impairment, but this is often not recognized. With improvement in acute stroke care, and with the ageing of populations, it is expected that more stroke survivors and more patients with cerebrovascular disease will need adequate management of cognitive impairment of vascular etiology. This document was conceived for the use of and for those clinicians involved in cerebrovascular disease, with specific and practical hints concerning diagnostic tools, cognitive impairment management and decision on some therapeutic options.Discussion and conclusions: It is essential to consider a possible cognitive deterioration in every patient who experiences a stroke. Neuropsychological evaluation should be adapted to the clinical status. Brain imaging is the most informative biomarker concerning prognosis. Treatment should always include adequate secondary prevention.
脑血管疾病和认知障碍患者的许多日常临床决策都很复杂。支持这些决策的循证信息常常缺失。本文旨在提出一种针对已知脑血管疾病患者认知障碍的实用临床方法。
该文件由欧洲卒中组织（ESO）痴呆委员会编写，基于现有文献证据以及委员会成员的临床经验。本文得到了ESO的认可。
许多中风或其他脑血管疾病患者存在认知障碍，但这往往未被识别。随着急性中风护理的改善以及人口老龄化，预计更多的中风幸存者和脑血管疾病患者将需要对血管性病因的认知障碍进行适当管理。本文件旨在供参与脑血管疾病治疗的临床医生使用，并提供有关诊断工具、认知障碍管理以及某些治疗选择决策的具体实用提示。讨论与结论：对于每一位经历中风的患者，都必须考虑到可能的认知恶化。神经心理学评估应根据临床状况进行调整。脑成像是关于预后最具信息量的生物标志物。治疗应始终包括充分的二级预防。
