课件：血管性认知障碍.pptVIP

小血管病变临床更多见, 从而引起相应的临床症状. 这里可以看到, 血管性痴呆的表现以执行功能障碍为主, 而AD以记忆障碍为早发和突出表现. Moderator Summary Binswanger described a small-vessel disease of the brain. The concept proved attractive and remains in use, although whether the syndrome exists as a separate entity is disputed. Undoubtedly, white matter subcortical changes do occur and are found in disease. They are readily detected on both CT and MRI neuroimaging. However, they also occur in ageing and are not specifically associated with the clinical syndrome described by Binswanger. User Notes None Found References Cummings JL., Vascular subcortical dementias: clinical aspects., Dementia, 1994, 5: 177?0., Unknown Pantoni L, Garcia JH., The significance of cerebral white matter abnormalities 100 years after Binswangers report. A review., Stroke, 1995, 26: 1293?01., Unknown Moderator Summary CADASIL is not common, but is important for three reasons. First, it is the only inherited vascular dementia. Second, it can be confused clinically with subcortical white-matter disease (Binswangers) and, third, because it is caused by mutations in Notch3, a gene also implicated in AD as an AD gene. Presenilin associates with Notch in the brain. The first signs are usually migraine and stroke, but the former may not be pronounced and the latter may be silent. Cases have presented with dementia early or first. The dementia is a characteristic subcortical slowing-up dementia. Pathological data show Binswangers disease-like macroscopic lesions in the small vessels, including thickening of the media and narrowing of the lumen. Skin biopsy can be used as a diagnostic tool as it can show ultrastructural alterations of skin vessels similar to those of brain vessels. User Notes None Found * Moderator Summary A consensus conference generated criteria for diagnosing vascular dementia (VaD) while acknowledging that this represents a heterogeneous group of conditions. The criteria were intended primarily for research purposes. ICD10 dementia