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Post Stroke Dementia Masafumi Ihara 1 1Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center Keyword: 脳卒中後認知症 , 脳卒中前認知症 , 血管性認知障害 , 血管性危険因子 , 神経変性 , poststroke dementia , prestroke dementia , vascular cognitive impairment , vascular risk factor , neurodegeneration pp.743-751
Published Date 2016/7/1
DOI https://doi.org/10.11477/mf.1416200506
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Abstract

Post-stroke dementia (PSD) is a clinical entity that encompasses all types of dementia following an index stroke. Current evidence suggests that 25-30% of ischemic stroke survivors develop immediate or delayed vascular cognitive impairment or vascular dementia. The type of stroke can be either ischemic, hemorrhagic or hypoperfusive. There are multiple risk factors for PSD including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischemic attack or recurrent stroke and depressive illness. Pre-stroke dementia refers to the occurrence of cognitive impairment before the index stroke, which may be caused by a vascular burden as well as insidious neurodegenerative changes. Neuroimaging determinants of dementia after stroke include silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Published clinical trials have not been promising and there is little information on whether PSD can be prevented using pharmacological agents. Control of vascular disease risk and prevention of recurrent strokes are key to reducing the burden of cognitive decline and post-stroke dementia. Modern imaging and analysis techniques will help to elucidate the mechanism of PSD and establish better treatment.


Copyright © 2016, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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