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Neuroradiological markers of Vascular Cognitive Impairment after Stroke

Background: Cognitive vascular impairment (CCV) is a frequent, but overlooked, possible consequence of stroke. Neuroimaging is essential for the evaluation of these patients with cognitive deficits supposedly secondary to vascular lesions, with Nuclear Magnetic Resonance (NMR) of the skull being the most sensitive method for identifying markers associated with CCV. The most relevant markers seem to be, among others, strategic location, severity of white matter changes, as well as the degree of atrophy of the medial temporal lobe. Objective: To assess the relationship between stroke and CCV using markers from skull MRI. Methodology: This is a systematic review of observational studies published between 2005 and 2020. The search was carried out in the PubMed and SciELO databases with the keywords consulted by the following MeSH and DeCS sites: “stroke”, “MRI”, “Vascular cognitive impairment”, using the boolean operator “and”. The PRISMA check-list was used to guide this review. Results: According to the eligibility criteria, eight studies were selected. “Event location” was the marker in MRI of the skull most frequently considered, being the object of evaluation in seven of the eight studies analyzed and proving to be a statistically significant marker (p <0.05) for the prediction of CCV in six of them. 75% of the studies included in this review evaluated the relationship between the presence of “hyperintensity in the white matter” at MRI and CCV. However, this marker was shown to be statistically significant in 50% of these studies. Conclusion: A review that brought together the assessment of a wide range of possible neuroradiological predictors of CVD after stroke had not been carried out so far. It would be particularly useful to evaluate the markers in a more homogeneous way in a study with a larger sample size, which would allow quantitative analysis to measure the influence of each predictor.