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(Stroke. 2007;38:7.)
© 2007 American Heart Association, Inc.

Editorials

Poststroke Cognition and the Fight Against the Hard Problem

Vascular Neurologists, Enter the Arena!

Jan Lodder, MD, PhD

From the Department of Neurology, University Hospital Maastricht, The Netherlands.

Correspondence to Dr Jan Lodder, Professor of Vascular Neurology, Department of Neurology, University Hospital Maastricht, PO Box 5800 6202 AZ, Maastricht, The Netherlands. E-mail jlod@sneu.azm.nl

See related article, pages 198–203

Key Words: cognitive impairment

An extract of the first 250 words of the full text is provided, because this article has no abstract.

In this issue of Stroke, Snaphaan and de Leeuw report on their results obtained from a systematic review on poststroke memory dysfunction.¹ Of the 798 articles their search strategy identified, only 5 mentioned memory testing at different poststroke intervals, only 3 studies followed patients for at least 1 year, whereas the largest study contained only 196 patients. The results of the review allow at least 2 conclusions. One is drawn by the authors, in that memory dysfunction, a key element in the "diagnosis" of poststroke dementia, does not follow a linear time course after stroke. Leys et al came to a similar conclusion with regard to poststroke dementia, which was defined as any dementia after stroke.² Short-term studies over-diagnose cognitive poststroke dysfunction. The finding warns us against making simple models of reality when it comes to poststroke cognitive impairment, and makes us aware that we should save our patients the embarrassment of early, false-positive predictions in this respect.

The second conclusion the review allows is that our current knowledge of poststroke cognitive impairment and its long-term development is rather poor, as illustrated by the review’s data on memory dysfunction, a key element in the diagnostic criteria for dementia. The poststroke dementia studies reviewed by Leys et al, although larger and with longer follow-up by some, did not provide any detail either except for the criteria that they used for the diagnosis.² One may question the value of studying any cognitive details when we can already make diagnoses such as . . . [Full Text of this Article]

Related Article:

Poststroke Memory Function in Nondemented Patients: A Systematic Review on Frequency and Neuroimaging Correlates

Liselore Snaphaan and Frank-Erik de Leeuw
Stroke 2007 38: 198-203. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				P. B. Gorelick and J. V. Bowler Advances in Vascular Cognitive Impairment 2007 Stroke, February 1, 2008; 39(2): 279 - 282. [Full Text] [PDF]