The Anatomical Substrate of Ischemic Vascular Dementia

  • J. H. Garcia
  • G. G. Brown
Conference paper


Cerebral vascular dementia (CVD) is defined as an impairment of memory and other cognitive or behavioral functions caused by brain lesions of either vascular or circulatory origin. CVD should be distinguished from focal neurologic syndromes caused by stroke, such as Wernicke’s aphasia or limb apraxia. The impairment of behavior caused by CVD is attributed to the direct effects of multiple cerebral infarcts (or brain lesions secondary to focal ischemia); and the severity of the dementia is thought to be directly related to the total volume of injured brain [19]. However, the location of the infarcts is also important in determining the degree or the type of dementia; small infarcts in the diencephalon and mesencephalon, in particular, can result in significant dementia [10].


Vascular Dementia Moyamoya Disease Anatomical Substrate Henry Ford Hospital Limb Apraxia 
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  1. 1.
    Babikian V, Ropper AH (1987) Binswanger’s disease: a review. Stroke 18:2–12PubMedCrossRefGoogle Scholar
  2. 2.
    Boller F, Lopez OL, Moossy J (1989) Diagnosis of dementia. Clinicopathologic correlations. Neurology 39:76–79PubMedGoogle Scholar
  3. 3.
    Cummings JL, Benson DF (eds) (1983) Dementia: a clinical approach. Butterworths, Boston, p 9Google Scholar
  4. 4.
    DeGirolami U, Crowell RM, Marcoux FW (1984) Selective necrosis and total necrosis in focal cerebral ischemia. J Neuropathol Exper Neurol 43:57–71CrossRefGoogle Scholar
  5. 5.
    Dubas F, Gray F, Roullet E et al. (1985) Leucoencephalopathies arteriopathiques. Rev Neurol 141(2):93–108PubMedGoogle Scholar
  6. 6.
    Fisher CM (1965) Lacunes: small deep cerebral infarcts. Neurology 15:774–784PubMedGoogle Scholar
  7. 7.
    Futrell N, Garcia JH, Millikan C (1990) Morphology of evolving microinfarctions in the rat brain. J Neuropathol Exper Neurol 49:301CrossRefGoogle Scholar
  8. 8.
    Gamble CN (1986) The pathogenesis of hyaline arteriolosclerosis Am J Pathol 122:410–420PubMedGoogle Scholar
  9. 9.
    Hachinski VC, Iliff LD, Zihka E et al. (1975) Cerebral blood flow in dementia. Arch Neurol 32:632–637PubMedCrossRefGoogle Scholar
  10. 10.
    Katz DI, Alexander MP, Mandell AM (1987) Dementia following strokes in the mesencephalon and diencephalon. Arch Neurol 44:1127–1133PubMedCrossRefGoogle Scholar
  11. 11.
    Loeb C, Gandolfo C (1983) Diagnostic evaluations of degenerative and vascular dementia. Stroke 14:399PubMedCrossRefGoogle Scholar
  12. 12.
    Marshall J (1988) Vascular and multi-infarct dementia. Do they exist? In: Meyer JS, Lechner H, Marshall J, Toole JF (eds) Vascular and multi-infarct dementia. Futura, New York, pp 1–3Google Scholar
  13. 13.
    Meyer JS (1988) The nature of reduced cerebral perfusion in vascular and multi-infarct dementia. In: Meyer JS, Lechner H, Marshall J, Toole JF (eds) Vascular and multi-infarct dementia. Futura, New York, pp 113–114Google Scholar
  14. 14.
    Moossy J, Martinez AJ, Hanin I et al. (1987) Thalamic and subcortical gliosis with dementia. Arch Neurol 44:510–513PubMedCrossRefGoogle Scholar
  15. 15.
    Pettegrew JW, Panchalingam K, Moossy J et al. (1988) Correlation of phosphorus-31 magnetic resonance spectroscopy and morphologic findings in Alzheimer’s Disease. Arch Neurol 45:1093–1096PubMedCrossRefGoogle Scholar
  16. 16.
    Revesz T, Hawkins CP, du Boulay EPG et al. (1989) Pathological findings correlated with magnetic resonance imaging in subcortical arteriosclerotic encephalopathy (Binswanger’s disease). J Neurol Neurosurg Psych 52:1337–1344CrossRefGoogle Scholar
  17. 17.
    Rosen TJ (1987) Cortical vs subcortical dementia: neuropsychological similarities (letter) Arch Neurol 44:131PubMedCrossRefGoogle Scholar
  18. 18.
    Rosen WE, Terry RD, Fuld PA et al. (1979) Pathological verification of ischemic score in differentiation of dementias. Ann Neurol 7:486CrossRefGoogle Scholar
  19. 19.
    Roth M (1981) Perspectives in the diagnosis of senile and presenile dementia of the Alzheimer type. In: Sarner M (ed): Advanced medicine no 18. Pittman, London, p 268Google Scholar
  20. 20.
    Starkstein S, Bolla-Wilson K, Robertson R (in press) The dementia syndrome of depression. In: Bornstein R, Brown GG (eds): Neurobehavioral aspects of cerebrovascular disease. Oxford University Press OxfordGoogle Scholar
  21. 21.
    Tierney MC, Fisher RH, Lewis AJ et al. (1987) The NINCDS-ADRDA Work Group criteria for the clinical diagnosis of probable Alzheimer’s disease: a clinicopathologic study of 57 cases. Neurology 44:131Google Scholar
  22. 22.
    Torvik A (1984) The pathogenesis of watershed infarcts in the brain. Stroke 15:221–223PubMedCrossRefGoogle Scholar
  23. 23.
    Volpe BT, Petito CK (1985) Dementia with bilateral medial temporal lobe ischemia. Neurology 35:1793–1797PubMedGoogle Scholar
  24. 24.
    Wells CE (1977) Definition and description. In: Wells CI (ed) Dementia, 2nd edn. Davis, Philadelphia, p 1Google Scholar
  25. 25.
    Whitehouse PJ (1986) The concept of subcortical and cortical dementia: another look. Ann Neurol 19:1–6PubMedCrossRefGoogle Scholar
  26. 26.
    Zubenko G, Moossy J (1988) Major depression in primary dementia. Clinical and neuropathologic correlates. Arch Neurol 45:1182–1186PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • J. H. Garcia
    • 1
  • G. G. Brown
    • 1
  1. 1.Neuropathology K-6Henry Ford HospitalDetroitUSA

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