Neurológia pre prax 4/2009

Vascular dementia

Vascular dementia can be considered as a consequence of ischemic or hemorrhagic damage to brain tissue that manifests with alteration of cognitive function. Thus it is a very heterogenic group of various clinical syndromes-from focal injury of corresponding area of a larger size to multiple deficits of cognitive domains within the scope of multiinfarct dementia, across comparatively homogenic profile of dysexecutive syndrome with bradypsychism and frequently depressive mood in subcortical ischemic leucoencefalopathy. Mixed dementia, mostly combinations of vascular encephalopathy and Alzheimer disease, are quite common. At present there is no effective treatment of vascular dementia (VaD). The most important preventive measures include a rigorous control of arterial hypertension, modification of other vascular risk factors and their adequate treatment and secondary prevention of ischemic strokes (antiplatelet therapy). Clinical studies show effect of acetylcholinesterase inhibitors even in VaD.

Keywords: vascular dementia, multiinfarct dementia, leucoencephalopathy, CADASIL, therapy of dementia.