Recovery after stroke: More than just walking and talking again If you don't look for it, you won't find it

摘要

Prevalence of dementia in the first months after stroke varies between 20 and 30 percent in hospital-based studies, mainly depending on whether pre-stroke dementia and prior stroke were excluded or not [1]. Vascular cognitive impairment not (yet) dementia (VCI-ND) is even more common after stroke, and its frequency is likely to increase with improving stroke survival; however, it remains often unrecognized and thus undiagnosed [2]. In this issue of the European Journal of Neurology, Planton et al. [3] show that patients with ischaemic stroke with total motor and language recovery performed worse on different cognitive functions and were more apathetic than controls. Forty percent of these apparently total recovered stroke patients had VCI-ND.Like stroke itself, post-stroke cognitive dysfunction is both clinically and etiologically a heterogeneous condition with multiple interacting determinants. To prevent further cognitive decline after stroke, we need to recognize cognitive dysfunction early and better understand its etiology. By focusing on apparently total recovered patients, performing extensive neuropsycho-logical assessments and neuroimaging, the authors shed new light on this underexposed subject.