(Binswanger’s Disease; Senile Dementia; Binswanger’s Type; Vascular Cognitive Impairment; Arteriosclerotic Dementia; Atherosclerotic Disease)
by Rick Alan
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.
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 TOP
Factors that may increase your chances of developing vascular dementia include:
In some patients, symptoms appear suddenly with neurologic 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 patients, the disease continues to progress.
The main symptoms of vascular dementia include:
Other symptoms that may be present include:
The symptoms of vascular dementia can resemble other causes of dementia, such as Alzheimer’s disease.
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.
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:
There are no definitive guidelines to prevent vascular dementia. However, the following may help reduce your risk:
National Institute of Neurological Disorders and Stroke
Alzheimer Society of Canada
Heart and Stroke Foundation of Canada
Binswanger’s disease—revisited. Neurology . 1995;45: 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;26:454-458.
Roman GC, Erkinjuntti T, Wallin A, et al. Subcortical ischaemic vascular dementia. Lancet Neurology . 2002;1:426-436.
Smith EE. Leukoariosis and stroke. Stroke . 2010;41(10 Suppl):S139-143.
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 dementia. Alzheimer's Association website. Available at: http://www.alz.org/dementia/vascular-dementia-symptoms.asp . Accessed July 29, 2013.
Vascular dementia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php Updated July 8, 2013. Accessed July 29, 2013.
Vascular dementia: a resource list. National Institute on Aging website. Available at: http://www.nia.nih... . Accessed July 29, 2013.
Last reviewed July 2013 by Rimas Lukas, MD; Michael Woods, MD
Last Updated: 5/11/2013