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Two fraternal publications co-authored by Professor Joanna Wardlaw in European Stroke Association Journal

Fraternal white papers from the links between stroke European Stroke Organisation Dementia Committee.

ESOTwo Fraternal Publications co-authored by Professor Joanna Wardlaw in European Stroke Association Journal.
 
Publication 1
Title:  "Cognitive impairment in patients with cerebrovascular disease: A white paper from the links between stroke ESO Dementia Committee".
 
Authors: Ana Verdelho, Joanna Wardlaw, Aleksandra Pavlovic, Leonardo Pantoni, Olivier Godefroy, Marco Duering, Andreas Charidimou, Hugues Chabriat and Geert Jan Biessels
 
Abstract
 
Purpose: Many daily-life clinical decisions in patients with cerebrovascular disease and cognitive impairment are complex. Evidence-based information sustaining these decisions is frequently lacking. The aim of this paper is to propose a practical clinical approach to cognitive impairments in patients with known cerebrovascular disease.
Methods: The document was produced by the Dementia Committee of the European Stroke Organisation (ESO), based on evidence from the literature where available and on the clinical experience of the Committee members. This paper was endorsed by the ESO.
Findings: Many patients with stroke or other cerebrovascular disease have cognitive impairment, but this is often not recognized. With improvement in acute stroke care, and with the ageing of populations, it is expected that more stroke survivors and more patients with cerebrovascular disease will need adequate management of cognitive impairment of vascular etiology. This document was conceived for the use of strokologists and for those clinicians involved in cerebrovascular disease, with specific and practical hints concerning diagnostic tools, cognitive impairment management and decision on some therapeutic options.
Discussion and conclusions: It is essential to consider a possible cognitive deterioration in every patient who experiences a stroke. Neuropsychological evaluation should be adapted to the clinical status. Brain imaging is the most informative biomarker concerning prognosis. Treatment should always include adequate secondary prevention.
 
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Publication 2

Title:  "Cerebrovascular disease in patients with cognitive impairment: A white paper from the ESO dementia committee – A practical point of view with suggestions for the management of cerebrovascular diseases in memory clinics"

Authors:  Ana Verdelho, Geert Jan Biessels, Hugues Chabriat, Andreas Charidimou, Marco Duering, Olivier Godefroy, Leonardo Pantoni, Aleksandra Pavlovic, and Joanna Wardlaw

 

Abstract

Purpose: Practical suggestions on clinical decisions about vascular disease management in patients with cognitive impairment are proposed.

Methods: The document was produced by the Dementia Committee of the European Stroke Organisation (ESO) based on the evidence from the literature where available and on the clinical experience of the Committee members. This paper was endorsed by the ESO.

Findings: Vascular risk factors and cerebrovascular disease are frequent in patients with cognitive impairment. While acute stroke treatment has evolved substantially in last decades, evidence of management of cerebrovascular pathology beyond stroke in patients with cognitive impairment and dementia is quite limited. Additionally, trials to test some daily-life clinical decisions are likely to be complex, difficult to undertake and take many years to provide sufficient evidence to produce recommendations. This document was conceived to provide some suggestions until data from field trials are available. It was conceived for the use of clinicians from memory clinics or involved specifically in cognitive disorders, addressing practical aspects on diagnostic tools, vascular risk management and suggestions on some therapeutic options.

Discussion and conclusions: The authors did not aim to do an exhaustive or systematic review or to cover all current evidence. The document approach in a very practical way frequent issues concerning cerebrovascular disease in patients with known cognitive impairment.

 

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