The long-term functional impairment of survivors of ischemic stroke has emerged as an increasingly pressing concern, and most stroke patients are afflicted with cognitive impairment and functional deficits. Compared with the general population, stroke patients exhibit significantly greater magnetic resonance imaging burden of cerebral small vessel disease (CSVD), which is associated with substantially elevated risks of post-stroke dementia, aggravated disability severity, and increased stroke recurrence rates. This article reviews existing researches, delving deep into the role and significance of the CSVD magnetic resonance imaging burden in the assessment of cognitive impairment and functional prognosis in patients with ischemic stroke. The results demonstrate that CSVD magnetic resonance imaging burden, whether assessed through a grading scoring method or quantitative analysis, shows significant correlations with cognitive function in patients with ischemic stroke, and the total CSVD magnetic resonance imaging burden exhibits high sensitivity in predicting functional prognosis of patients with ischemic stroke. Therefore, this indicator holds great promise in providing pivotal support for aspects such as monitoring disease progression and formulating personalized treatment strategies.In the future, it will be imperative to establish multicenter prospective cohorts to further elucidate the relationship between the CSVD magnetic resonance imaging burden and the long-term prognosis of patients with ischemic stroke.

The long-term functional impairment of survivors of ischemic stroke has emerged as an increasingly pressing concern, and most stroke patients are afflicted with cognitive impairment and functional deficits. Compared with the general population, stroke patients exhibit significantly greater magnetic resonance imaging burden of cerebral small vessel disease (CSVD), which is associated with substantially elevated risks of post-stroke dementia, aggravated disability severity, and increased stroke recurrence rates. This article reviews existing researches, delving deep into the role and significance of the CSVD magnetic resonance imaging burden in the assessment of cognitive impairment and functional prognosis in patients with ischemic stroke. The results demonstrate that CSVD magnetic resonance imaging burden, whether assessed through a grading scoring method or quantitative analysis, shows significant correlations with cognitive function in patients with ischemic stroke, and the total CSVD magnetic resonance imaging burden exhibits high sensitivity in predicting functional prognosis of patients with ischemic stroke. Therefore, this indicator holds great promise in providing pivotal support for aspects such as monitoring disease progression and formulating personalized treatment strategies.In the future, it will be imperative to establish multicenter prospective cohorts to further elucidate the relationship between the CSVD magnetic resonance imaging burden and the long-term prognosis of patients with ischemic stroke.