Vascular dementia

There is a loss of attention and concentration, mental and physical fatigue. Mood swings, depression or aggressive behavior, hallucinations, paranoia occur. Changes such as falling into unreasonable crying or laughing are characteristic. Speech is difficult, he cannot remember adequate words, he becomes simple, he uses phrases …

There are several types of dementia, of which vascular dementia is the second most common, right after Alzheimer’s. Today’s findings speak in favor of the mixed type. Both types of dementia are thought to be more common in one person.

Vascular dementia

In addition to the generally poor flow in the blood vessels of the brain (insufficiency), damage to the brain tissue after bleeding, diseases of the blood vessels of the brain such as, e.g., temporal arteritis or systemic diseases, e.g., Lupus erythematosus, the basic changes that lead to vascular dementia are changes in the arteries due to atherosclerosis.

They can lead to a complete cessation of flow in the artery and stroke, or they can be diffuse when narrowing of the smaller arteries leads to insufficient flow and poor supply to the brain. In this case, there are so-called “silent strokes” seen on CT or MR of the brain but do not appear clinically as true strokes.

Anyone who survives a stroke does not develop vascular dementia. Approximately one-third of patients are thought to develop signs of vascular dementia 6 months after recovering from a stroke.

Clinical picture

Due to strokes, vascular dementia can, unlike Alzheimer’s, occur more abruptly. Also, deteriorations and improvements occur by leaps and bounds.
What will be dominant in the clinical picture of dementia depends on the damage site.

Unlike the already mentioned Alzheimer’s dementia, there are also focal signs of brain damage such as weakness of one arm and leg or individually, speech, vision, balance disorders. There are difficulties in walking in terms of drift. Besides, there is a loss of control of urination and stool and the already mentioned changes in memory and behavior.

Risk factors

1st age – occurs mainly after 65. years
2. overcame a stroke
3. high blood pressure
4. diabetes
5. Elevated blood cholesterol

Basically, all the mentioned risk factors lead to changes in the blood vessels, which leads to tissue damage due to reduced supply. We can also mention smoking, increased body weight, reduced movement.

Diagnostic methods

Existing changes in the brain and the brain’s blood vessels can be well represented today on CT or MR of the brain and color Doppler of the blood vessels of the neck and blood vessels of the base of the brain.

Therapy

There is currently no specific therapy in the treatment of vascular dementia. Because in most cases, it occurs together with Alzheimer’s dementia, it is believed that the use of drugs registered for its treatment may also help with vascular dementia. These are cholinesterase inhibitors (e.g., donepezil, galantamine, and rivastigmine).

Equally valuable for memantine. What remains in the primary and secondary prevention of vascular dementia is treating existing risk factors.

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