Hostname: page-component-745bb68f8f-d8cs5 Total loading time: 0 Render date: 2025-01-14T19:17:43.117Z Has data issue: false hasContentIssue false
  • English
  • Français

Natural History of the Vascular Dementias: A Prospective Study of Seven Cases

Published online by Cambridge University Press:  18 September 2015

Linda A. Hershey ,
Michael T. Modic ,
David F. Jaffe  and
P. Gregg Greenough
Linda A. Hershey*
Affiliation:
Departments of Neurology and Radiology, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Ohio
Michael T. Modic
Affiliation:
Departments of Neurology and Radiology, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Ohio
David F. Jaffe
Affiliation:
Departments of Neurology and Radiology, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Ohio
P. Gregg Greenough
Affiliation:
Departments of Neurology and Radiology, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Ohio
*
Department of Neurology # 127, Veterans Administration Medical Center, 3495 Bailey Avenue, Buffalo, New York, U.S.A.
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The clinical course of vascular dementia has been described as a stepwise deterioration over time. We studied the chronologic course of cognitive performance over 1-4 years in seven patients with known ischemic cerebrovascular disease whose dementia subtype was assigned according to the clinical history and the pattern of white matter lesions seen on magnetic resonance imaging (MRI). One patient had the lacunar state, three had subcortical arteriosclerotic encephalopathy and three had multiple cortical and subcortical strokes. All were being treated with an antiplatelet agent and six received antihypertensive therapy. Four of the seven vascular dementia patients improved cognitively over the first year. A fluctuating course was eventually seen in all patients. None showed stepwise deterioration of cognitive function over time. The MRI was useful in subclassifying vascular dementia patients, but the clinical course did not appear to vary as a function of the dementia subtype.

Type
Imaging of Demented Subjects
Information
Canadian Journal of Neurological Sciences , Volume 13 , Issue S4 , November 1986 , pp. 559 - 565
Copyright
Copyright © Canadian Neurological Sciences Federation 1986

References

1.Cummings, JL, Benson, DF.Dementia in vascular and infectious disorders. In: Cummings, JL, Benson, DF, eds. Dementia: A Clinical Approach. Boston: Butterworths, 1983: 125–143.Google Scholar
2.Ishii, N, Nishihara, Y, Imamura, T.Why do frontal lobe symptoms predominate in vasculardementia with lacunes? Neurology 1986; 36: 340–345.CrossRefGoogle Scholar
3.Rogers, RL, Meyer, JS, Mortel, K.F, et al. Decreased cerebral blood flow precedes multi-infarct dementia, but follows senile dementia of Alzheimer type. Neurology 1986; 36: 1–6.CrossRefGoogle ScholarPubMed
4.Erkinjuntti, T, Sipponen, JT, Iivanainen, M, et al. Cerebral NMR and CT imaging in dementia. JCAT 1984; 8: 614–618.Google ScholarPubMed
5.DeWitt, LD.Clinical use of nuclear magnetic resonance imaging in stroke. Stroke 1986; 17: 328–331.CrossRefGoogle ScholarPubMed
6.Kinkel, WR, Jacobs, L, Polachini, I, et al. Subcortical arteriosclerotic encephalopathy (Binswanger’s disease). Arch Neurol 1985, 42: 951–959.CrossRefGoogle ScholarPubMed
7.Hershey, LA, Modic, MT, Greenough, PG, et al. Magnetic resonance imaging in vascular dementia. Neurology (in press).Google Scholar
8.Caplan, LR, Schoene, WC.Clinical features of subcortical arterioscleroticencephalopathy(Binswangerdisease). Neurology 1978; 28: 1206–1215.CrossRefGoogle Scholar
9.Fromm, D, Holland, AL, Swindell, CS, et al. Various consequences of subcortical stroke. Arch Neurol 1985; 42: 943–950.CrossRefGoogle ScholarPubMed
10.American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd ed. Washington, DC: American Psychiatric Association, 1980: 107–112.Google Scholar
11.Jacobs, JW, Bernhard, MR, Delgado, A, et al. Screening for organic mental syndromes in medically ill. Ann Int Med 1977; 86: 40–45.CrossRefGoogle ScholarPubMed
12.Pfeffer, RI, Kurosaki, TT, Harrah, CH Jr, et al. Measurement of functional activities in older adults in the community. J Gerontol 1982; 37: 323–329.CrossRefGoogle ScholarPubMed
13.Hachinski, VC, lliff, LD, Zilhka, E, et al. Cerebral blood flow in dementia. Arch Neurol 1975; 32: 632–637.CrossRefGoogle ScholarPubMed
14.Crooks, LE, Mills, CM, Davis, PL, et al. Visualization of cerebral and vascular abnormalities by NMR imaging. The effects of imaging parameters on contrast. Radiology 1982; 144: 843–852.CrossRefGoogle ScholarPubMed
15.Ratcliffe, PJ, Wilcock, GK.Cerebrovascular disease in dementia: the importance of atrial fibrillation. Postgrad Med J 1985; 61: 201–204.CrossRefGoogle ScholarPubMed
16.Dougherty, JH, Simmons, JD, Parker, J.Subcortical ischemic disease: clinical spectrum and MR1 correlation. Stroke 1986; 17: 146.Google Scholar
17.Mayeux, R, Stern, Y, Spanton, S.Heterogeneity in dementia of the Alzheimer type: Evidence of subgroups. Neurology 1985; 35: 453–461.CrossRefGoogle ScholarPubMed
18.Hollister, LE, Yesavage, J.Ergoloid mesylates for senile dementias: unanswered questions. Ann Int Med 1984; 100: 894–898.CrossRefGoogle ScholarPubMed