Psychiatr. pro Praxi, 2007; 2: 81-84

Vascular dementia

MUDr. Robert Rusina¹, MUDr. Radoslav Matěj^2,3

¹ Neurologická klinika IPVZ, Fakultní Thomayerova nemocnice Praha

² Národní referenční laboratoř pro diagnostiku lidských TSE/CJD (NRL TSE/CJD) při Oddělení patologie Fakultní Thomayerovy nemocnice, Praha

³ Ústav dědičných metabolických poruch 1. LF UK a VFN, Praha

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 adequate treatment and secondary prevention of ischemic strokes (antiplatelet therapy). Among a number of vasoactive and supportive substances without sound evidence in clinical trials, the use of pentoxyphyllin and extracts of ginkgo biloba have the most of evidence. Clinical studies show effect of acetylcholinesterase inhibitors even in VaD.

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

Published: April 1, 2007  Show citation