title: Influence of cognitive impairment on the management of ischaemic stroke.
abstract: BACKGROUND
  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.
authors.affiliation: EA 1046, Departments of Neurology, University Lille North of France, UDSL, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France.
authors.forename: K
authors.initials: K
authors.lastname: Murao
authors.affiliation: EA 1046, Departments of Neurology, University Lille North of France, UDSL, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France; Departments of Neurology, Memory Centre, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France. Electronic address: stephanie.bombois@chru-lille.fr.
authors.forename: S
authors.initials: S
authors.lastname: Bombois
authors.affiliation: EA 1046, Departments of Neurology, University Lille North of France, UDSL, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France; Departments of Neurology, Stroke centre, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Cordonnier
authors.affiliation: EA 1046, Departments of Neurology, University Lille North of France, UDSL, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France; Departments of Neurology, Stroke centre, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Hénon
authors.affiliation: EA 1046, Departments of Neurology, University Lille North of France, UDSL, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France; Department, of Pharmacology. Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France.
authors.forename: R
authors.initials: R
authors.lastname: Bordet
authors.affiliation: EA 1046, Departments of Neurology, University Lille North of France, UDSL, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France; Departments of Neurology, Memory Centre, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Pasquier
authors.affiliation: EA 1046, Departments of Neurology, University Lille North of France, UDSL, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France; Departments of Neurology, Stroke centre, Lille University Hospital, 1, place de Verdun, 59045 Lille cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Leys
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002545:Brain Ischemia / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000517:prevention & control; D003072:Cognition Disorders / Q000150:complications*; D032882:Comprehension; D019299:Decompression, Surgical / Q000706:statistics & numerical data; D048909:Diabetes Complications / Q000517:prevention & control; D019468:Disease Management; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy; D016894:Endarterectomy, Carotid / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007003:Hypoglycemia / Q000209:etiology / Q000517:prevention & control; D064887:Observational Studies as Topic; D010353:Patient Education as Topic; D010361:Patients / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D012307:Risk Factors; D055502:Secondary Prevention; D017131:Thrombectomy; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D000959:Antihypertensive Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
keywords: AVC ischémique; Acute stroke; Alzheimer disease; Cognitive disorders; Démence vasculaire; Maladie d’Alzheimer; Patient outcome assessment; Troubles cognitifs; Vascular dementia; Évaluation du devenir