[Vascular dementia].

Abstract

The vast majority of senile dementia consists of Alzheimer's disease and vascular dementia. However, there appear to be geographic differences in the world in the ratio of these two disorders and the types of vascular dementia prevalent in the regions: multi-infarct dementia, lacunar infarct dementia or Binswanger disease. Partly because of those factors, there have been considerable confusions in the classification and diagnostic criteria of vascular dementia. In order to clarify the confusions, it is necessary to recognize the presence of both dementias caused by multiple infarcts as the results of atherothrombosis and embolism, and those caused by multiple lacunar infarcts and periventricular white matter ischemic lesions. Since the clinical manifestations of different types of vascular dementia may be different, it is also necessary to establish the diagnostic criteria which is applicable to all different types of vascular dementia. In order to comprehend the clinicopathologic characteristics of vascular dementia, it is always necessary to analyze the location of arterial occlusion and the mechanism leading to the arterial occlusion.