Vascular Dementia Flashcards
1
Q
What is Vascular Dementia?
A
- Common form of dementia caused by cerebrovascular disease
- CVD - vascular brain injury/ dysfunction as a result of conditions that impair cerebral blood flow including chronic small vessel disease, stroke or haemorrhage
2
Q
What is the pathophysiology of Vascular Dementia?
A
- Vascular dementia occurs secondary to disorders of the cerebral vasculature
- Causes:
1. Ischaemic Stroke,
2. Small Vessel disease,
3. Haemorrhage,
4. Cerebral Amyloid
3
Q
What is CADASIL?
A
- An autosomal dominant inherited condition
- Due to a mutation in the NOTCH3gene and leads to arterial thickening and occlusion
- Recurrent migraine type headaches, multiple strokes and progressive dementia
4
Q
What are the Clinical Features of Vascular Dementia?
A
- Stepwise cognitive decline
- Post - stroke Dementia - Stepwise cognitive decline following a clinically diagnosed stroke
- Vascular dementia without recent stroke - stepwise cognitive decline without history of symptomatic stroke
- Mood disturbances are common = psychosis, delusions, hallucinations and paranoia
5
Q
What features are supportive of vascular aetiology ?
A
- Onset in temporal association with cerebrovascular event
- Predominant decline in frontal executive function and attention
- On clinical assessment and neuroimaging
6
Q
How do you manage Vascular Dementia?
A
- Addressing CVS risk - Anti-hypertensives, diabetic medications/ insulin, anti-lipid therapy, increasing exercise, reduce salt intake, eat healthier
- Pharmacological therapy - acetylcholinesterase inhibitors and N-methyl- D- aspartic acid receptors
7
Q
What are the risk factors for Vascular Dementia?
A
- High BP
- Smoking
- High Cholesterol
- Lack of exercise
- Being overweight/ obese
- Diabetes
- Drinking too much alcohol
8
Q
What would you see on imaging for Vascular dementia?
A
- ## blurring between the white and the grey matter
