Vascular dementia


 * brain damage by heart attacks
 * at least 100ml of tissue is damaged to cause dementia
 * with larger CMPs and smaller volume
 * mainly small arteries, thrombosis, embolism and bleeding
 * often arise suddenly and quickly, often with a history of stroke or ischemic heart disease
 * typical – fluctuating course in a short time horizon
 * the personality is preserved for a long time → they are aware of the disease for a long time → frequent depression
 * often additional neurological symptoms
 * frequent polymobility, sometimes even delirium
 * 15-30% of dementia

Vascular dementia with acute onset

 * after one more extensive heart attack, mainly in the areas of cognitive functions
 * thalamus, gyrus angularis, frontal area

Multi-infarct dementia

 * multiple small infarcts, mainly in the cortical area
 * often together with hypertension, smokers, hyperlipidemia

Subcortical vascular dementia (Binswanger's disease)

 * on the basis of hypertensive encephalopathy
 * involvement of white matter infarcts - demyelination
 * the course is different

Other types of ischemic-vascular dementias

 * sometimes status lacunaris is isolated separately – relatively mild dementia on the basis of hypertension

Diagnostics

 * the course and pre-disease, as well as the image, are important
 * risk factors - hypertension, stroke, smoking...

Therapy

 * complex as in other dementias
 * rehabilitation of intercurrent diseases - mainly hypertension, diabetes mellitus,...
 * antioxidants, nootropics…
 * additionally anticoagulants – ASA, heparin