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The Vascular Dementias and Cerebrovascular Involvement in Alzheimer’s Disease

  • J. G. Schulz
  • K. M. Einhäupl
Conference paper
Part of the Ernst Schering Research Foundation Workshop book series (SCHERING FOUND, volume 17)

Abstract

The blood stream is a trade route between the brain and the rest of the body. It provides various nutrients and clears waste products, receives and delivers signals, may be blocked or disrupted, and exposes the brain to harmful and unknown external agents. How disturbed vascular trafficking in the brain may end in a syndrome that presents clinically as dementia may be categorized in the following way:
  1. 1.

    Global cerebral ischemia due to cardiogenic dysfunction (watershed infarcts)

     
  2. 2.

    Focal cerebral ischemia due to vascular occlusion (multi-infarct dementia, MID; strategic infarct)

     
  3. 3.

    Chronic hypoperfusion due to functional changes of the cerebral microvasculature (Binswanger’s disease, Alzheimer’ s disease, AD?)

     
  4. 4.

    Cerebral hemorrhage due to focal weakness of the cerebrovasculature (intracerebral hemorrhage, amyloid angiopathy)

     
In acute ischemic processes with complete infarction the clinical picture directly depends upon how large a lesion is and where it is located, because the brain tissue involved is simply lost for further use. This occurs instantaneously and can be detected by neuroimaging. In contrast, whether and how chronic ischemic processes or incomplete infarction may affect the brain may depend upon further unknown variables. They are not necessarily detected by neuroimaging and do not coincide with onset of clinical symptoms. As a consequence, it is difficult to attribute slowly progressing dementia to underlying vascular causes. Therefore such causes may be underestimated and remain to be elucidated.

Keywords

Down Syndrome Vascular Dementia Cerebral Amyloid Angiopathy White Matter Change Amyloid Beta Protein 
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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© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • J. G. Schulz
  • K. M. Einhäupl

There are no affiliations available

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