Back

Vascular Dementia

(Binswanger’s Disease; Senile Dementia; Binswanger’s Type; Vascular Cognitive Impairment; Arteriosclerotic Dementia; Atherosclerotic Disease)

Definition

Vascular dementia is a type of dementia. It is caused by disease of the small blood vessels in the brain. Parts of the brain called white matter along with grey matter are injured by multiple small strokes.
Healthy and Injured Brain Blood Vessels
Blood Flow and Lack of Blood Flow to the Brain
Copyright © Nucleus Medical Media, Inc.

Causes

Vascular dementia occurs when cells below the surface of the brain's cortex die because they do not receive enough oxygen and nutrients. This process is due to hardening and narrowing of the blood vessels within the white matter of the brain. This affects the blood supply.

Risk Factors

Factors that may increase your chance of vascular dementia include:

Symptoms

In some people, symptoms appear suddenly with neurological changes like those caused by a stroke. Sometimes, the small strokes that lead to vascular dementia can happen without other symptoms. This makes the condition difficult to detect.
In some cases, symptoms may stabilize or even improve. However in most people, the disease continues to progress.
The main symptoms of vascular dementia include:
Other symptoms that may be present include:

Diagnosis

The symptoms of vascular dementia can resemble other causes of dementia, such as Alzheimer's.
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Pictures may be taken of your brain and bodily structures. This can be done with:
Your heart and brain activity may be evaluated. This can be done with:
Your bodily fluids may be tested. This can be done with blood tests.

Treatment

There is no known cure for vascular dementia. Reducing risk factors and symptoms are important in trying to slow disease progression and improve quality of life.
Medications can be given to help limit or control symptoms and possibly slow progression of the disease. These include:

Prevention

There are no definitive guidelines to prevent vascular dementia. However, the following may help reduce your risk:

RESOURCES

Alzheimer’s Association http://www.alz.org

National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov

CANADIAN RESOURCES

Alzheimer Society of Canada http://www.alzheimer.ca

Heart & Stroke Foundation http://www.heartandstroke.com

References

Caplan LR. Binswanger’s disease—revisited. Neurology. 1995;45(4):626-633.

Kirschner H. Vascular dementia: a review of recent evidence for prevention and treatment. Curr Neurol Neurosci Rep. 2009;9(6):437-442.

Roman GC. Brain hypoperfusion: a critical factor in vascular dementia. Neurol Res. 2004;26(5):454-458.

Roman GC, Erkinjuntti T, Wallin A, Pantoni L, Chui HC. Subcortical ischaemic vascular dementia. Lancet Neurol. 2002;1(7):426-436.

Smith EE. Leukoariosis and stroke. Stroke. 2010;41(10 Suppl):S139-S143.

Tomassoni D, Lanari A, Silvestrelli G, Traini E, Amenta F. Nimodipine and its use in cerebrovascular disease: evidence from recent preclinical and controlled clinical studies. Clin Exp Hypertens. 2008;30(8):744-766.

Vascular cognitive impairment. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 8, 2013. Accessed July 29, 2013.

Vascular dementia. Alzheimer's Association website. Available at: http://www.alz.org/dementia/vascular-dementia-symptoms.asp. Accessed July 29, 2013.

Vascular dementia: A resource list. National Institute on Aging website. Available at: https://www.nia.nih.gov/alzheimers/vascular-dementia-resource-list. Accessed July 29, 2013.

9/3/2014 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed: Wippold FJ, Brown DC, Broderick DF, et al. American College of Radiology (ACR) Appropriateness Criteria for dementia and movement disorders. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/DementiaAndMovementDisorders.pdf. Updated 2014. Accessed September 3, 2014.

Revision Information