Cerebral vasomotor reactivity and dementia after ischemic stroke

Objectives - Cerebral hemodynamic features of patients with post-stroke dementia (PSD) are still obscure. We compared cerebral vasomotor reactivity (VMR) assessed in the acute phase of ischemic stroke (IS) in patients with and without PSD. VMR was also assessed and compared in demented and non-demented patients in the late phase of IS. Materials and methods - VMR was assessed by transcranial Doppler and the Diamox test (1 g acetazolamide i.v.). PSD was confirmed by the National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et I'Enseignement en Neurosciences (NINDS-AIREN) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. VMR% values were compared to verify correlation with dementia. Results - Thirty patients with acute IS (AIS) were studied and followed for 3-6 months. An additional group of 37 patients was studied in the late post-stroke period (PIS). VMR% values in the AIS groups with and without PSD were similar (25.3 +/- 20.3% and 36.5 +/- 22.4%, respectively, NS). The mean VMR% in the PIS groups with and without PSD were similar (32.3 +/- 19.5% and 41.2 +/- 24.8%, respectively, NS). Conclusions - VMR cannot predict the development of dementia after AIS and cannot identify patients with dementia in the late phase of stroke.