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Published on: December 16, 2022
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Predicting post-stroke cognitive impairment using acute CT neuroimaging: A systematic review and meta-analysis
Emily L Ball1, Rachel Sutherland2, Charlotte Squires2
1Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Summary
Brain computed tomography scans can identify acute stroke patients at risk of cognitive decline. Features like white matter lesions and cerebral atrophy are linked to post-stroke dementia and cognitive impairment.
Area of Science:
- Neurology
- Radiology
- Cognitive Science
Background:
- Identifying cognitive decline risk in acute stroke patients is crucial for prognosis and management.
- Routine computed tomography (CT) neuroimaging in acute stroke may predict post-stroke dementia or cognitive impairment (PSCI).
Purpose of the Study:
- To systematically review literature associating acute stroke or pre-stroke CT scan features with post-stroke dementia or PSCI.
- To identify specific CT imaging markers predictive of cognitive impairment after stroke.
Main Methods:
- Systematic literature search of electronic databases up to December 2020.
- Included 28 studies (7078 participants) analyzing acute stroke CT scans and later cognitive outcomes.
- Performed meta-analyses on data from 15 studies to estimate the association between CT features and cognitive outcomes.
Main Results:
- White matter lesions (WML), cerebral atrophy, and pre-existing stroke lesions were associated with post-stroke dementia.
- WML showed a significant association with post-stroke cognitive impairment (PSCI).
- Other CT features had insufficient data or no significant association with cognitive outcomes.
Conclusions:
- Visual assessment of acute stroke CT scans reveals features strongly associated with cognitive outcomes.
- Clinicians should consider discussing these imaging findings with stroke survivors to manage expectations and plan care.
- CT-identified features offer valuable prognostic information for cognitive decline after stroke.
