卒中后认知障碍临床诊疗实践面临的挑战

Challenges in Clinical Practice of Post-Stroke Cognitive Impairment

卒中后认知障碍(post-stroke cognitive impairment,PSCI)是指在卒中事件后6个月内发生的任何程度的认知损害。因为卒中患者常出现失语、失用和失认,所以PSCI的神经心理学评估不同于一般的成套评估,需要选取合适的测验,否则容易高估患者的认知损害程度。PSCI病因具有复杂性,需要全面考虑,除了卒中的病因之外,还需要考虑与脑储备相关的脑病理背景,如脑小血管病和神经系统变性病。对于PSCI的治疗,病因及对症治疗、药物和非药物治疗都很重要。

Post-stroke cognitive impairment(PSCI)refers to any severity of cognitive impairment within six months after a stroke.Because stroke usually leads to aphasia,apraxia and agnosia,neuropsychological assessment of PSCI should be different from general assessment battery,and appropriate examination should be chosen to avoid overestimation of the severity of cognitive impairment.The etiology of PSCI is complex and needs to be comprehensively considered.In addition to the etiology of stroke,the background of brain pathology related to brain reserve should also be considered,such as cerebral small vessel disease and neurodegene-rative diseases.For the treatment of PSCI,etiological and symptomatic treatment,drug and non-drug treatment are very important.