Vascular dementia is the third most common cause of dementia . It is caused by disease of the small blood vessels in the brain. Parts of the brain called white matter (as well as subcortical grey matter) are injured, often by multiple small strokes .
Vascular dementia occurs when cells below the surface of the brain (the cortex) receive an inadequate supply of oxygen and nutrients and, in turn, die. This process is due to hardening of the blood vessels within the white matter of the brain, which affects the blood supply. As a result, the oxygen and nutrient supply to the neurons and their supporting cells are also affected.
The exact cause is unknown. However, factors that play a role in causing the disease include:
Vascular dementia usually affects older individuals. Vascular dementia and Alzheimer’s dementia can occur together, making the diagnosis of one over the other difficult. Other factors that increase the risk of the disease include:
In some patients, symptoms appear suddenly with neurologic changes like those caused by a stroke. Sometimes, the small strokes that lead to vascular dementia can happen without other symptoms. This makes the condition difficult to detect.
In some cases, symptoms may stabilize or even improve. However, in most patients, the disease continues to progress.
The main symptoms of vascular dementia include:
Other symptoms that may be present in people with this disease include:
The symptoms of vascular dementia can resemble other causes of dementia, such as Alzheimer’s disease .
Your doctor will ask about your symptoms and medical history and perform a physical exam. Tests may include:
There is no known cure for vascular dementia. Most patients die within 5-10 years after onset of the disease. Minimizing risk factors and alleviating symptoms are important in trying to slow disease progression and improve quality of life.
Medications can be given to help limit or control symptoms and possibly slow progression of the disease. These include:
There are no definitive guidelines for the prevention of vascular dementia. However, the following may help reduce your risk:
RESOURCES:
Alzheimer’s Association
http://www.alz.org/
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/
National Organization for Rare Diseases
http://www.rarediseases.org/
CANADIAN RESOURCES:
Alzheimer Society of Canada
http://www.alzheimer.ca/
Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/
References:
Aminoff MJ, Greenberg DA, Simon RP. Disorders of cognitive function. Clinical Neurology, Access Medicine website. Available at: http://www.accessmedicine.com/content.aspx?aID=2079000 . Accessed February 4, 2009.
American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html .
Binswanger’s disease—revisited. Neurology . 1995;45: 626-633.
Bowler JV, Hachinski V. Vascular Dementia. In: Gilman S, ed. MedLink Neurology website. Available at http://www.medlink.com . Accessed February 4, 2009.
National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov .
Roman GC. Brain hypoperfusion: a critical factor in vascular dementia. Neurol Res . 2004;26:454-458.
Roman GC, Erkinjuntti T, Wallin A, et al. Subcortical ischaemic vascular dementia. Lancet Neurology . 2002;1:426-436.
Ropper AH, Brown RH. Degenerative diseases of the nervous system. Adams and Victor's Principles of Neurology, Access Medicine website. Available at: http://www.accessmedicine.com/content.aspx?aID=976498 . Accessed February 4, 2009.
Vascular dementia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php Updated January 24, 2009. Accessed February 4, 2009.
Last reviewed January 2009 by J. Thomas Megerian, MD, PhD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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