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Vascular Dementia


  • Results from death of neurones as a result in disruption of blood flow
  • Blood flow disruption can result from haemorrhage, clot, and watershed infarcts due to hypotensive episodes
  • Diseased blood vessels greatly pre-disposes to vascular dementia
    • T2DM
    • HTN
    • Hypercholesterolaemia
  • Size of vessel effected plays a role in symptoms seen
    • Large vessels with associated stroke symptoms
    • Smaller vessels acting as small stroke or TIA
      • Stroke symptoms may be so small they are not noticed, or resolve as in TIA, but with dementia symptoms persisting
    • Sub-cortical small vessels giving no stroke symptoms but if extensive gives dementia
  • Early symptoms
    • Memory loss less prominent than Alzheimer’s
    • Mental retardation and fluctuating attention
    • Problem solving and complex task issues
  • Later symptoms
    • Memory loss, visuospatial difficulties, word-finding problems
    • Harder to distinguish from Alzheimer’s
  • Frequent overlap with Alzheimer’s
  • Diagnosis relies on PMH of risk factors, step-wise deteriorations seen in dementia symptoms, CT head commonly shows white matter changes and evidence of infarcts


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