Vascular cognitive impairment: epidemiology, subtypes, diagnosis and management
Dementia occurs after stroke in 25% of patients but also can arise
from covert cerebrovascular disease (CVD). ‘Silent’ lacunes occur in 25% of the
elderly, often associated with focal or confluent hyperintensities on T2-weighted
magnetic resonance imaging, which are detected in 95% of seniors. These covert
infarcts predict future stroke and faster cognitive decline. Best practice guidelines
advocate screening for cognitive impairment in all phases of overt stroke, when
covert CVD is uncovered, when vascular risk factors are present and if patients