Stroke is a disease caused by interrupted blood supply to the brain, which can lead not only to physical damage but also a range of cognitive impairments. Post-stroke cognitive impairment is like a dense fog in the brain—your keys, name, and appointment times seem to disappear, your attention drifts like a butterfly, and your thoughts feel bound as if by tape, with slowed movements.
The Concept and Definition of Post-Stroke Cognitive Impairment
Cognition refers to the brain’s process of receiving, processing, and converting external information into internal mental activities, thereby acquiring and applying knowledge. Post-stroke cognitive impairment is a clinical syndrome characterized by persistent cognitive deficits that continue for up to six months after a stroke incident.
Why do some individuals maintain clear cognition after a stroke while others do not? This is closely related to the specific brain regions affected; damage to critical areas like the frontal lobe, middle frontal gyrus, angular gyrus, and basal ganglia is more likely to result in cognitive impairment.
Diagnosis and Assessment of Post-Stroke Cognitive Impairment
CT or MRI imaging is the first step in diagnosis, but neuropsychological evaluation is also required to diagnose post-stroke cognitive impairment. Common clinical screening tools include the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Further assessment should evaluate the five core cognitive domains: executive function, attention, memory, language, and visuospatial abilities. Near-infrared brain imaging can also provide objective functional assessments.
Symptoms and Manifestations of Post-Stroke Cognitive Impairment
Patients find themselves lost in a memory fog; names, locations, and details that were once easily recalled now disappear in the mist. Attention seems to play hide-and-seek, impossible to grasp for long. Thought processes become disoriented and sluggish, hampering comprehension and responsiveness. In the haze of post-stroke cognitive impairment, patients may feel their brain is a broken jigsaw puzzle, struggling to express themselves clearly, turning simple tasks complex, and often feeling confused and unable to issue correct instructions.
The treatment methods for post-stroke cognitive impairment are:
-Scientifically Rational Management
Once lost in the cognitive fog, scientifically rational management can help improve the patient’s quality of life.Pharmacological Treatment
-Prescription medications like cholinesterase inhibitors and memantine, taken as directed, can improve the patient’s cognitive function.
-Rehabilitation Therapy
This includes psychological interventions and cognitive training. Emerging non-invasive brain stimulation techniques like transcranial magnetic stimulation, transcranial direct current stimulation, and transcutaneous vagus nerve stimulation can also enhance the patient’s working memory and attention.
-Adaptation to Daily Life
Using reminder tools like written logs can help patients better manage their daily tasks.
-Social Support
Family, friends, and social support networks are crucial for the patient’s rehabilitation and improving their adaptive capacity.
In summary, the primary goals of treatment are to delay further cognitive decline, improve cognitive abilities, alleviate behavioral and psychological symptoms, and enhance daily living skills.
Preventive Measures for Post-Stroke Cognitive Impairment
Research suggests that 90% of strokes and a third of dementias may be preventable. Medical guidelines recommend the following preventive measures for cognitive impairment:
-Maintain a healthy body mass index for those over 65 years old, with regular weight monitoring.
- Undergo regular checkups and avoid developing hypertension, diabetes, hyperlipidemia, and hyperhomocysteinemia, with routine blood pressure and blood glucose monitoring.
- Adopt a healthy lifestyle with a diet rich in fruits, vegetables, and grains, while limiting salt and sugar intake, to maintain cerebrovascular health.
- Maintain good psychological well-being and actively engage in social activities to stimulate the brain and support cognitive health. Avoid excessive stress and engage in cognitive exercises like memory games and mental training.
- Protect the head and prevent brain injuries.
- Receive as much education as possible in early life.
Overcoming cognitive impairment is a challenge, but through proactive prevention and comprehensive management, its impact can be minimized. Specialized rehabilitation professionals and therapists can also provide valuable assistance.
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Post time: Jun-14-2024