Predicting post-stroke cognitive impairment using acute CT neuroimaging: A systematic review & meta-analysis Link to paper on International Journal of Stroke Authors Emily L Ball, Rachel Sutherland, Charlotte Squires, Gillian E Mead, Dorota Religa, Erik Lundström, Joshua Cheyne, Joanna M Wardlaw, Terence J Quinn, Susan D Shenkin Abstract Background: Identifying whether acute stroke patients are at risk of cognitive decline could improve prognostic discussions & management. Structural computed tomography neuroimaging is routine in acute stroke, & may identify those at risk of post-stroke dementia or post-stroke cognitive impairment (PSCI). Aim: To systematically review the literature to identify which stroke or pre-stroke features on brain computed tomography scans, performed at the time of stroke, are associated with post-stroke dementia or PSCI. Summary of review: We searched electronic databases to December 2020. We included studies reporting acute stroke brain computed tomography, & later diagnosis of a cognitive syndrome. We created summary estimates of size of unadjusted association between computed tomography features & cognition. Of 9536 citations, 28 studies (41 papers) were eligible (N = 7078, mean age 59.8–78.6 years). Cognitive outcomes were post-stroke dementia (10 studies), PSCI (17 studies), & one study analyzed both. Fifteen studies (N = 2952) reported data suitable for meta-analyses. White matter lesions (WML) (six studies, N = 1054, OR = 2.46, 95% CI = 1.25–4.84), cerebral atrophy (four studies, N = 558, OR = 2.80, 95% CI = 1.21–6.51), & pre-existing stroke lesions (three studies, N = 352, OR = 2.38, 95% CI = 1.06–5.32) were associated with post-stroke dementia. WML (four studies, N = 473, OR = 3.46, 95% CI = 2.17–5.52) were associated with PSCI. Other computed tomography features were either not associated with cognitive outcome, or there were insufficient data. Conclusions: Cognitive impairment following stroke is of great concern to patients & carers. Features seen on visual assessment of acute stroke computed tomography brain scans are strongly associated with cognitive outcomes. Clinicians should consider when & how this information should be discussed with stroke survivors. Keywords Cognitive impairment Computed tomography Dementia Neuroimaging Stroke Related links Link to paper on International Journal of Stroke Professor Joanna Wardlaw Brain & nervous system Stroke Dementia What is a CT scan? Social media tags & titles Featured paper: Predicting post-stroke cognitive impairment using acute CT neuroimaging: A systematic review & meta-analysis @EdinUniBrainSci Publication date 05 Oct, 2021