A Clinical Trial of Pentoxifylline in Vascular Dementia

  • R. S. Black
  • L. L. Barclay
  • S. T. Hardiman
  • J. P. Blass
Conference paper


Damage to the brain from vascular disease is, after Alzheimer’s disease, the second most common cause of the dementia syndrome. Longitudinal studies have demonstrated that approximately 10%-20% of patients with the dementia syndrome have vascular dementia; an approximately equal percentage have “mixed dementia” in which degenerative and vascular causes both contribute to the cognitive impairment [23,33]. The actual incidence of vascular brain damage in demented patients may be even higher. In a study in which serial coronal sections were stained with Weigert’s stain, Brun and Englund [6] found significant vascular damage to white matter in 30 of 48 demented patients who met clinical and neuropathological research criteria for Alzheimer’s disease (63%). The term “multi-infarct dementia” assumes that the pathophysiology in the large majority of cases is multiple, usually small, cerebral infarctions [13]. Such multiple infarcts tend to affect white matter more often than gray, leading to a “lacunar state” [13,21,24]. However, other mechanisms of vascular damage to white matter also occur, including those described originally by Binswanger [4]. Patients with such diffuse white matter damage are clinically heterogeneous; they may develop significant abnormalities of motor function, such as gait disturbances, or may be clinically indistinguishable from patients with Alzheimer’s disease [1,6,7]. Typical pathological findings include thinning of axons, loss of myelin, hyalinzation of smaller vessels, and varying degrees of edema [4].


White Matter Magnetic Resonance Imaging Scan Vascular Dementia Vascular Damage White Matter Damage 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • R. S. Black
    • 1
  • L. L. Barclay
    • 1
    • 3
  • S. T. Hardiman
    • 2
  • J. P. Blass
    • 1
  1. 1.Dementia Research ServiceCornell University Medical College at the Burke Rehabilitation CenterWhite PlainsUSA
  2. 2.Section of BiostatisticsHoechst-Roussel Pharmaceuticals, Inc.SomervilleUSA
  3. 3.Department of NeurologyUniversity of South FloridaTampaUSA

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