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Vol 6, No 1 (2004)
Prace poglądowe
Published online: 2004-01-26
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Neuropathology of vascular dementia

Przemysław Nowacki, Marta Nowik
Udar Mózgu. Problemy Interdyscyplinarne 2004;6(1):17-26.

open access

Vol 6, No 1 (2004)
Prace poglądowe
Published online: 2004-01-26

Abstract

Apart from Alzheimer’s disease, cerebrovascular disorders are the second most frequent cause of dementia in elderly. Vascular dementia (VaD) is generated by heterogeneous group of diseases in terms of etiology, histopathology and clinical appearance. Vascular lesions and vasculogenic changes in the brain associated with small and large vessel disease have been reported. In some cases the development of dementia is associated with cerebrovascular lesions and Alzheimer’s-type pathology. Small vessel diseases that contribiute to global cognitive decline in setting of a clinical dementia are mainly lacunar infarcts, Binswanger disease, vasculitis, connective tissue systemic disorders, antiphospholipid antibody syndrome, cerebral autosomal dominaiting arteriopathy with subcortical infarcts and leucoencephalopthy (CADASIL), pseudoxanthoma elasticum, hereditary endotheliopathy-retinopathy-nephropathy-stroke (HERNS), hereditary hemorrhagic teleangiectasia (Rendu-Osler-Weber syndrome), as well as sporadic and familial amyloidoses. Pathology of large vessels, predominantly of atherosclerotic origin, results in multi infarct dementia (MID), dementia due to single strategic infarct as well as dementia related to hippocampal sclerosis. Fibromuscular dysplasia belongs to this group as well. Moyamoya disease is characterised by both small and large vessel pathology.
The VaD is mainly associated with injury to the white matter. Neuropathological, genetic and molecular findings prove that in many cases of dementia both, cerebrovascular and Alzheimer’s-type pathology play an important role. That combination may lead to earlier appearance and faster progress of dementia.

Abstract

Apart from Alzheimer’s disease, cerebrovascular disorders are the second most frequent cause of dementia in elderly. Vascular dementia (VaD) is generated by heterogeneous group of diseases in terms of etiology, histopathology and clinical appearance. Vascular lesions and vasculogenic changes in the brain associated with small and large vessel disease have been reported. In some cases the development of dementia is associated with cerebrovascular lesions and Alzheimer’s-type pathology. Small vessel diseases that contribiute to global cognitive decline in setting of a clinical dementia are mainly lacunar infarcts, Binswanger disease, vasculitis, connective tissue systemic disorders, antiphospholipid antibody syndrome, cerebral autosomal dominaiting arteriopathy with subcortical infarcts and leucoencephalopthy (CADASIL), pseudoxanthoma elasticum, hereditary endotheliopathy-retinopathy-nephropathy-stroke (HERNS), hereditary hemorrhagic teleangiectasia (Rendu-Osler-Weber syndrome), as well as sporadic and familial amyloidoses. Pathology of large vessels, predominantly of atherosclerotic origin, results in multi infarct dementia (MID), dementia due to single strategic infarct as well as dementia related to hippocampal sclerosis. Fibromuscular dysplasia belongs to this group as well. Moyamoya disease is characterised by both small and large vessel pathology.
The VaD is mainly associated with injury to the white matter. Neuropathological, genetic and molecular findings prove that in many cases of dementia both, cerebrovascular and Alzheimer’s-type pathology play an important role. That combination may lead to earlier appearance and faster progress of dementia.
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Keywords

vascular dementia; neuropathology; pathogenesis; clinical manifestations

About this article
Title

Neuropathology of vascular dementia

Journal

Interdisciplinary Problems of Stroke

Issue

Vol 6, No 1 (2004)

Pages

17-26

Published online

2004-01-26

Bibliographic record

Udar Mózgu. Problemy Interdyscyplinarne 2004;6(1):17-26.

Keywords

vascular dementia
neuropathology
pathogenesis
clinical manifestations

Authors

Przemysław Nowacki
Marta Nowik

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