David S. Knopman Dementia p. 113-134 February 2004, Vol.10, No.1 doi: 10.1212/01.CON.0000293549.18598.4e
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Vascular dementia (VaD) is more common than appreciated and increases in incidence with advancing age. VaD is heterogeneous and consists of several syndromes: strategic single infarcts in locations such as medial thalamus, hippocampus, caudate nucleus, and parietal lobe; multiple large infarcts; multiple lacunar infarcts; predominantly subcortical white matter infarcts; and various infarct types combined with Alzheimer's disease. The diagnosis of VaD is based on several features, the most important of which are the occurrence of a stroke temporally related to dementia onset and the presence of bilateral cortical or subcortical infarcts on imaging. Treatment of VaD with cholinesterase inhibitors provides symptomatic benefits. Significant challenges to research in VaD are defining the importance of microvascular disease and learning how to recognize it clinically.

© 2004 American Academy of Neurology