Clinical aspects and neurobiology of vascular dementia
Authors:
F. Koukolík
Authors place of work:
Primář: MUDr. František Koukolík DrSc.
; Národní referenční laboratoř prionových chorob
; Fakultní Thomayerova nemocnice s poliklinikou, Praha
; Oddělení patologie a molekulární medicíny
Published in the journal:
Prakt. Lék. 2008; 88(1): 17-21
Category:
Various Specialization
Summary
The first book on vascular dementia (VD) is more than 450 years old; nevertheless epidemiology, signs and symptoms, pathogenesis, prevention and therapy of VD are currently discussed more than ever. The clinical research uses several types of diagnostic criteria of VD (e.g. ICD-10, DSM-IV, NINCDS-AIREN, and ADDTC) which may identify different patient groups in the same cohort. Sensitivity and specificity of those criteria are not very high, results are therefore easily misinterpreted. The situation is complicated by frequent occurrence of Alzheimer’s disease (AD) in conjunction with VD. VD as AD are clinical and neuropathological continua with subliminal and clinical evolution and possible, probable and definite diagnosis. The same problem burden with clinical diagnostic criteria charges neuropathological diagnosis too: the practice and interpretation us not identical in different laboratories. Most frequent neuropathology in VD is a conjunction of cerebral embolism with large and small vessel disease resulting in „infarcts large and small“ and/or Binswanger´s disease. Less frequent causes of VD are sporadic and familial cerebral amyloid angiopathy, CADASIL and vasculitides. Cerebral amyloid angiopathy accompanies AD in about 90% cases; vascular encephalopathy is therefore common in AD too. Behaviour disturbances in VD are due to focal damage of cerebral cortex and white matter and due to more diffuse damage of white matter. Focal neurological signs and symptoms and damage of cognition, e.g. of executive functions, memory, attention and praxia thus manifest.
Key words:
vascular dementia, epidemiology, pathogenesis, diagnostic criteria, brain-behaviour correlation.
Zdroje
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Štítky
Addictology Allergology and clinical immunology Anaesthesiology, Resuscitation and Inten Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric dermatology & STDs Paediatric gastroenterology Paediatric gynaecology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric clinical oncology Paediatric ENT Paediatric pneumology Paediatric psychiatry Paediatric radiology Paediatric urologist Diabetology Endocrinology Pharmacy Clinical pharmacology Physiotherapist, university degree Gastroenterology and hepatology Medical genetics Geriatrics Gynaecology and obstetrics Haematology Hygiene and epidemiology Hyperbaric medicine Vascular surgery Chest surgery Plastic surgery Medical virology Intensive Care Medicine Cardiac surgery Clinical speech therapy Clinical microbiology Nephrology Neonatology Neurosurgery Neurology Nuclear medicine Nutritive therapist Obesitology Ophthalmology Orthodontics Orthopaedics ENT (Otorhinolaryngology) Anatomical pathology Paediatrics Pneumology and ftiseology Burns medicine Occupational medicine General practitioner for children and adolescents General practitioner for adults Orthopaedic prosthetics Clinical psychology Radiodiagnostics Radiotherapy Rehabilitation Reproduction medicine Nurse Sexuology Forensic medical examiner Dental medicine Sports medicine Toxicology Trauma surgery Urology Laboratory Home nurse Phoniatrics Health Care Dental Hygienist Medical studentČlánok vyšiel v časopise
General Practitioner
2008 Číslo 1
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