Historical Perspective

  • José G. Merino
  • Vladimir Hachinski

The idea that brain softening leads to cognitive decline dates at least from the 19th century (Ball & Chambard, 1881; Browne, 1874; Durand-Fardel, 1843; Rostan, 1823). The study of patients with stroke has provided important insights on how the brain functions, but over the past 150 years many issues about the relationship between cerebrovascular disease and cognitive decline have been, and still are, hotly debated.

A key question has been the mechanism through which cerebrovascular disease leads to cognitive decline: some writers postulated that dementia due to cerebrovascular disease is a question of strokes while others supported the idea that chronic ischemia is the main pathogenic mechanism. Current views hold that strokes, chronic ischemia, and other mechanisms play a role.

Another important topic of debate has been whether cerebrovascular disease is the major cause of cognitive decline in the elderly or whether it is only the culprit in a small proportion of cases. In the first...


Cerebrovascular Disease Vascular Dementia Senile Dementia Carotid Occlusion Vascular Cognitive Impairment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Section on Stroke Diagnostics and TherapeuticsNational Institute of Neurological Disorders and Stroke, National Institutes of HealthBethesdaUSA

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