Article

Because of ageing of the population, it is more and more frequent to
treat ischaemic stroke patients with pre-stroke cognitive impairment (PSCI).
Currently, there is no specific recommendation on ischaemic stroke management in
these patients, both at the acute stage and in secondary prevention. However,
these patients are less likely to receive treatments proven effective in
randomised controlled trials, even in the absence of contra-indication.
OBJECTIVE: To review the literature to assess efficacy and safety of validated
therapies for acute ischaemic stroke and secondary prevention in PSCI patients.
RESULTS: Most randomised trials did not take into account the pre-stroke
cognitive status. The few observational studies conducted at the acute stage or
in secondary prevention, did not provide any information that the benefit could
be either lost or replaced by harm in the presence of PSCI. CONCLUSIONS: There is
no reason not to treat ischaemic stroke patients with PSCI according to the
currently available recommendations for acute management and secondary
prevention. Further observational studies are needed and pre-stroke cognition
should be taken into account in future stroke trials.
CI - Copyright (c) 2014 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS