Vascular dementia

Description, Causes and Risk Factors:Abbreviation: VD.Deterioration in intellectual functions with focal neurologic signs, as the result of multiple infarctions of the cerebral hemispheres.Types May Include:
  • Vascular dementia of acute onset following a stroke sometimes called post-stroke dementia. Multi-infarct Dementia: Subacute onset with step wise decline in following a number of mini strokes or transient ischemic attacks in outer parts of the brain called cerebral cortex.
  • Subcortical Vascular Dementia: This mainly happens due to ischemic damage results in loss of the covering sheath of nerve fibers in the brain.
  • Mixed cortical and subcortical vascular dementia.
Vascular dementia can be caused in several different ways. The most common cause is a blockage of small blood vessels deep within the brain. When any part of the body is deprived of blood which carries oxygen and nutrients it dies and this is called an infarct. When this happens in the brain it is called a stroke. Depending on where the stroke occurs in the brain different functions of the brain will be affected. Each side of the brain controls the movement on the other side of the body, thus strokes on the left side of the brain can cause problems in moving the limbs on the right side of the body and vice versa.Risk Factors:
  • Narrowing and furring of the main arteries in the neck supplying blood to the brain.
  • High blood pressure.
  • Raised cholesterol.
  • Diabetes.
  • Myocardial infarction.
  • Atrial fibrillation.
  • Smoking and illicit drug use.
Vascular dementia accounts for almost 20% of all cases of dementia, with at least another 20% of people having both Alzheimer's disease.Symptoms:Symptoms may include:
  • Dizziness.
  • Leg or arm weakness.
  • Tremors.
  • Moving with rapid, shuffling steps.
  • Balance problems.
  • Loss of bladder or bowel control.
Neurologic symptoms May Include:
  • Slowed thinking.
  • Forgetfulness.
  • Unusual mood changes.
  • Hallucinations and delusions.
  • Confusion, which may get worse at night.
  • Personality changes and loss of social skills.
  • Slurred speech.
  • Language problems, such as difficulty finding the right words for things.
  • Getting lost in familiar surroundings.
  • Laughing or crying inappropriately.
  • Difficulty planning, organizing, or following instructions.
  • Difficulty doing things that used to come easily.
Diagnosis:Vascular dementia is diagnosed based on history, symptoms, signs, and tests, and by ruling out other causes of dementia, including dementia due to metabolic causes. Imaging procedures which gives the detailed picture of brain to find reasons for strokes and blocked arteries is important. A neuropsychologist can diagnose the nature and level of cognitive mutilation. A neurologic examination shows variable deficits depending on the extent and location of damage. There may be multiple, focal neurologic deficits. Weakness or loss of function may occur on one side or only in one area. Abnormal reflexes may be present. There may be signs of cerebellar dysfunction such as loss of coordination. Several assessment tools, such as the modified Hachinski Ischemic Score, may help differentiate vascular dementia from Alzheimer's disease. Many patients who present with classic vascular dementia ultimately have Alzheimer's disease on postmortem examination of the brain, so the true relationship is likely to be complex.Treatment:There is no know cure for vascular dementia. Focus is mainly on preventing further brain damage by improving blood circulation. However, medications used for Alzheimer's are used sometimes by doctors. The medication is used mainly to prevent further strokes. Cholinesterase inhibitors are generally prescribed by doctors.The focus depends on managing the cardiovascular system. The caretaker should keep the track of blood pressure, pulse, blood sugar and sometimes cholesterol. All these factors impact to the blood flow and to the brain and its health.The other major element of treatment can be changes in lifestyle and behavioral management strategies. It helps in managing the patient and the situation till certain level.Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 


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