Vascular dementia Flashcards
Aetiology
Strokes
IHD -
Atheroma
What is the temporal lobe responsible for?
- Smell
- Memory
- Hearing
What is the frontal lobe responsible for?
- movement
- Decision making
- Personality
- Spelling/counting
What is the occipital lobe responsible for?
Sight
What is the Parietal lobe responsible for?
- Analyses sensory information
- recognition of faces
How much blood goes to the brain?
1/4 of all blood from heart
Through carotid and vertebral arteries
Is the damage permanent
Yes- liquefactive necrosis
Symptoms for VD
Varies depending on the area located
sudden
Brain function decreases with each stroke
Investigations for VD
MSSE
CT/MRI- cortical/ subcortical infarcts
Treatment for VD
No specific treatment for vascular dementia
Treatment aims at reducing CHD
NB do not use memantine/Ach inhibitors in these patients
AD Pathology
Loss of neurones in the brain
- Plaques- beta amyloid- form outside neurones/ in-between neurones and interfere with signalling
- These plaques can also develop around the blood vessels leading to rupturing- can lead to reduced blood flow
- Tangles- found inside the neurone.
What happens in the brain in AD?
As neurone die: the brain atrophies
- gyri get narrower
- sulci get wider.
- Ventricles get larger
Aetiology
Sporadic- late onset- majority.
Familial- dominant gene which speeds up disease.
Which disease is associated with AD?
Down’s
Presentation of AD?
- SHORT TERM first
- Loss of motor skills
- Language
- Loss of LONG TERM MEMORY
Investigation of AD
By exclusion of other dementias
Treatment of AD?
Avoid drugs like affect cognition e.g. sedatives, TCAs…
- Ach inhibitors e.g. rivastagmine, galantamine and donepezil for mild
- Antiglutaminergic: mementine for severe
- Antipsycotics
- Vitamin supplements
How does Lewy body dementia present?
- Functional cognitive impairment
- Visual Hallucinations
- Parkinsonisms
Aetiology of Lewy body dementia?
Presence of Lewy bodies in the brainstem
what to remember in treatment of LB dementia?
DO NOT GIVE ANTIPSYCOTICS
