Vascular dementia

Question 1

What are DSM-IV criteria for VaD?

Answer 1

Impairment in memory + at least one other domain
Co-occurrence of focal neurologic signs and symptoms of neuroimaging evidence of causally related CVD
Impairment in social and/or occupational functioning

Question 2

What is the underlying neuropathology of VaD?

Answer 2

Multiple small vessel disease with leukoencephalopathy and lacunar infarctions
Large-vessel occlusive disease
Multiple hemorrhagic lesions

Question 3

What is leukoaraiosis?

Answer 3

White matter abnormalities observed in the elderly, nonspecific density of subcortical white matter,
synonymous with periventricular white matter disease

Question 4

What is multi-infarct dementia?

Answer 4

Associated with multiple cerebral infarctions, with cerebral volume loss, often involves lesions of the cerebral cortex

Question 5

What is a strategic infarct?

Answer 5

Involves lesions of vasculature supplying the left angular gyrus region, the caudate nucleus, the globus pallidus, and thalamus

Question 6

What is a lacunar infarct?

Answer 6

Areas of ischemic necrosis of < 15 mm, involves perforating arteries supplying the thalamus and subcortical and brainstem structures

Question 7

What are features of cerebral amyloid angiopathy?

Answer 7

Amyloid deposition in blood vessels resulting in repeated hemorrhage
Ischemic infarction
Cognitive loss

Question 8

What is CADASIL?

Answer 8

Hereditary nonatherosclerotic arteriopathy
Affects the cerebral small vessels
Results in diffuse white matter disease and small lacunar infarctions

Clinical presentation: migraine, recurrent TIA, and stroke

Question 9

What is lipohyalinosis?

Answer 9

Reduced diameter of small-vessel wall lumen secondary to vessel wall thickening

Question 10

What are metabolic disease that can cause cerebral white matter disease?

Answer 10

Folate deficiency, vitamin B12 deficiency, hypoxia

Question 11

What are substances that can contribute to cerebral white matter disease?

Answer 11

Chemotherapy, radiation therapy, solvent exposure, carbon monoxide poisoning

Question 12

What are NP deficits associated with VaD?

Answer 12

Deficits in attention, EF, and slowed processing speed

Question 13

What does Binswanger’s disease involve?

Answer 13

Periventricular white matter disease, lacunar infarcts in the thalamus, BG, and surrounding WM