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 Vascular Dementia (VaD)

  • the second most common type of dementia accounting for 5-10% of all dementias [1]

  • VaD can result from a number of syndromes associated with cerebrovascular disease and is characterized by an abrupt onset and a stepwise decline [7]

  • can occur as a result of either a ischemic, hypoperfused or hemorrhagic brain lesion [7]

  • subcortical ischemic vascular dementia refers to lesions that involve the basal ganglia, cerebral white matter and the brainstem and is the most common cause of cognitive decline and  VaD in the elderly [7]

  • it occurs as a result of two mechanisms which often can overlap:  1) ischemic injury leading to complete infarction  i.e. lacunar infarcts and microinfarcts or 2) incomplete infarctions of the cerebral white matter [7]

  • Roman et al (2002) note that a significant proportion of subcortical lacunes are clinically silent and unnoticed until cognitive function deteriorates; this signifies the importance of primary prevention [7]

  • common signs and symptoms include loss of executive functioning, decreased memory (particularly retrival problem), mood disorders, slowed thinking and gait disturbances

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1. Dugue M, Neugroschl J, Sewell M, Marin D. Review of dementia. Mount Sinai Journal of Medicine 2003; 70:45-53.

7. Roman G, Erkinjuntti T, Wallin A, Pantoni L, Chui HC. Subcortical ischaemic vascular dementia. Lancet 2002 Nov; 1:426-437.

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