Stroke-Related Cognitive Dysfunction

Cognitive dysfunction after stroke is a common clinical finding and correlates with stroke localization and severity of stroke, as well as the timing of the cognitive assessment, which should be performed using standardized and established testing procedures. Cognitive dysfunction after stroke is relevant to functional outcome in the context of so-called post-stroke dementia. Importantly, the presence of cognitive dysfuntion is associated with an increased likelihood of recurrent stroke. Therefore, cognitive deficits as a possible consequence of stroke should necessarily get attention also beyond acute stroke care and early rehabilitation, particularly, as there is no stroke aftercare concept established in Germany to date. Not only cerebrovascular events themselves, but also the presence of corresponding vascular risk factors (e. g. atrial fibrillation, heart failure, hypercholesterolemia, and renal insufficiency) may contribute to the development and exacerbation of cognitive dysfunction after stroke. As long as a specific medical treatment approach for post-stroke cognitive dysfunction is not available, optimized treatment of risk factors and a healthy lifestyle have to be recommended. In addition, targeted rehabilitation after stroke may support improvement of cognitive function. Prospective (randomized) stroke trials should implement a standardized assessment of cognitive endpoints, and ideally focus on preventive therapeutic strategies for post-stroke cognitive dysfunction.