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VASCULAR DEMENTIA

MUST NOT MISS DIAGNOSIS


VASCULAR DEMENTIA
• Associated with focal damage in a random patchwork of cortical or
subcortical regions or white matter tracts that disconnect nodes
within distributed network
• Dementia associated with cerebrovascular disease
• Two general categories
• Multi-infarct dementia
• Diffuse white matter disease (aka. Leukoaraiosis, subcortical arteriosclerotic
leukoenchephalopathy or Binswanger’s disease)
Multi-infarct dementia
• Occurrence depends on the total volume of damaged cortex
• Most common in individuals with left-hemisphere lesion
• Report previous discrete episode of sudden neurologic deterioration
• History of hypertension, diabetes and coronary artery disease
Diffuse White Matter Disease
• Bilateral abnormalities of subcortical white matter
• Association with lacunar infarction
• Insidious in onset and progressive slowly
• Early symptoms
• Mild confusion, apathy, changes in personality, depression, psychosis, memory or executive
deficits
• Late symptoms
• Decrease judgment, orientation, decrease capacity to do daily activities, mood changes,
aggressive behavior
Patient’s Data

-(+) The patient is 85 Hypertension


years old Diabetes
-Cognitive deficit Coronary artery disease
-Asian Hemiparesis
Epidemiology
• Common in persons age 60-70
Age

• More common in men


Sex

• More common cause of dementia in Asian


Race

Risk Factor • hypertension, heart disease, diabetes, and other manifestations of widespread atherosclerosis.
History
Mild confusion

Apathy

Psychosis

Anxiety

Difficulties in judgment and orientation and dependence on other for daily activities

Memory, spatial or executive deficit

Euphoria, depression/ aggressive behaviors are common as disease progress


Physical Examination

Hemiparesis

Unilateral Babinski sign

Visual defect

Pseudobulbar palsy
Pathophysiology

Multiple Progressive Loss VASCULAR


Risk Factors Atherosclerosis
Strokes/Infracts of Brain Function DEMENTIA
CELLULAR FREE RADICAL
RISK FACTORS
DEPOLARIZATION PRODUCTION

FAILURE OF DAMAGE BRAIN


ATHEROSCLEROSIS
MITOCHONDRIA CELLS

LACUNAR BRAIN
NECROSIS
INFARCTION INFARCTION

BRAIN TISSUE
REDUCTION OF
DEATH WITHIN 4-
BLOOD FLOW
10 min
Diagnostic Criteria
Screening and Confirmatory test
• MRI
References
• American Psychiatric Association: Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text Revision. Washington, DC,
American Psychiatric Association, 2000.
• Harrison’s Principle of Internal Medicine 19th edition Chapter 450 page
2605
• Handbook of clinical psychiatry 5th ed
• https://www.mayoclinic.org/diseases-conditions/vascular-
dementia/symptoms-causes/syc-20378793
PEER GRADING
NAME OF MEMBER TASK DONE PEER GRADE
Idica, Ma. Isabel Definition, Clinical Presentation 10/10

Jamito. Ma. Isabel Pathophysiology, Pertinent Data 10/10

Jandoc, Angeles Jeanette Diagnostic Criteria 10/10


Powerpoint Compilation
Labasan, Jariah Anton Video planning editor 10/10