UK Stroke Forum 2025 | Cognitive outcomes associated with lacunar ischemic stroke

Lacunar ischemic stroke is typically a physically quite mild type of stroke. Sometimes people aren’t admitted to hospital, they’re okay to be managed at home. But it does have a high cognitive burden and the thing that seems to bother people most as they recover from a lacunar stroke is the cognitive impacts so for example they might start to go back to work or think about going back to work and they find that simple things they used to be able to do like working out how to solve a problem or you know how to organize something is just much less straightforward than it used to be. And I think it’s true that stroke in general has not concentrated so much on cognition because it’s been focused on trying to help the physical side. And because lacunar stroke typically isn’t usually physically as disabling, the cognitive side has been a bit neglected. But somewhere in the region of about half of people after a lacunar stroke, possibly slightly more, say that their single biggest concern is their cognitive function. Well, partly because a huge amount of stroke research, quite rightly, has focused on trying to minimize the physical impacts of stroke so trying to improve how people recover so they can walk again so that they can use both hands so they can see properly there’s been less attention given to the cognitive side. So we actually know very little and there’s very little in current routine practice to try and improve the cognitive outcomes. A lot of it’s geared towards making you know rehabilitation is largely about the physical consequences and there’s very little about actually trying to improve the cognitive outcomes so we don’t have any established treatments example, that we know for sure will help recover and improve cognitive function. So it’s a big problem.

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