Abstract

Stroke-related dementia (SRD) is a multifaceted and intricate clinical entity that emerges from the intricate interplay between vascular and neurodegenerative processes. This comprehensive review delves into the pathophysiological mechanisms, diagnostic challenges, and therapeutic strategies associated with SRD. The primary objective is to elucidate the complex cascade of events that ensue following a stroke, leading to cognitive decline and the manifestation of dementia.

The pathological substrates of SRD encompass both acute and chronic vascular insults, including ischemic and hemorrhagic strokes, cerebral small vessel disease, and cerebral hypoperfusion. These vascular events often trigger neuroinflammation, oxidative stress, and disruption of the blood-brain barrier, creating an environment conducive to neurodegenerative changes. A significant focus of this review is devoted to exploring the intertwining of vascular and neurodegenerative pathways, examining how they synergistically contribute to cognitive impairment in SRD. The diagnostic challenges of SRD are highlighted, emphasizing the need for a multidisciplinary approach that incorporates neuroimaging, neuropsychological assessments, and cerebrospinal fluid biomarkers. The evolving landscape of diagnostic criteria, including recent advancements in neuroimaging techniques, is discussed to improve the accuracy of SRD diagnosis and differentiation from other forms of dementia. In terms of therapeutic interventions, the review presents an overview of current pharmacological and non-pharmacological approaches. The intricate balance between managing vascular risk factors and targeting neurodegenerative pathways is explored, with a focus on emerging therapeutic strategies that aim to mitigate both aspects of SRD.

The review concludes with a discussion on the importance of early intervention, personalized treatment plans, and ongoing research efforts aimed at unraveling the complexities of SRD. A comprehensive understanding of the intricate relationship between vascular and neurodegenerative mechanisms is crucial for advancing effective prevention and management strategies for SRD.