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

Links

References

BENEŠ, Jiří. Studijní materiály [online]. [cit. 10.03.2010]. <http://jirben.wz.cz>.