Vascular Dementia

Question 1

What is the clinical progression of vascular dementia like?

Answer 1

Abrupt onset and stepwise progression
Contrast to gradual onset and progression of Alzheimers disease

Question 2

What vascular dementia?

Answer 2

Progressive + irreversible impairment in cognition, memory, communication and personality.
2nd most common type of dementia
Caused by damage to blood vessels (ischemia or haemorrhage) secondary ot cerebrovascular disease- causing impaired blood supply and damage to the brain.

Question 3

What are the risk factors for vascular dementia?

Answer 3

History of stroke or TIA
Atrial fibrillation
HTN
DM
Hyperlipidaemia
Smoking
Obesity
Coronary heart disease
A family history of stroke or cardiovascular disease.

Question 4

What are the main subtypes of vascular dementia?

Answer 4

Stroke related VD - muli-infarct or single infarct dementia
Subcortical VD - small vessel disease
Mixed dementia - the presence of both VD and Alzheimers disease.

Question 5

What are some typical symptoms of vascular dementia?

Answer 5

Focal neurological abnormalities e.g visual disturbances, sensory or motor symptoms
Difficulty with attention and concentration
Seizures
Memory disturbance
Gait disturbance
Speech disturbance
Emotional disturbance
Must have temporal relation of vascular and neurologic symptoms
Must have decreased cognition in 2 or more areas.

Question 6

How might vascular dementia appear on radiological imaging?

Answer 6

Multiple microbleeds = amyloid angiopathy - found on susceptibility-weighted imaging (left)
Hyperintensifies white matter detected using FLAIR sequences (right)