Vascular dementia: a changing concept.

Abstract

The traditional concept of vascular dementia implied the thickening of arteries of the brain as a source of diffuse reduction of cerebral blood flow leading to neuronal death, cerebral atrophy, and finally dementia. Although this concept has been recently revived, with the increasing use of brain imaging technologies, new concepts of vascular dementia came into view. Present classification tends to separate various pathomechanisms (large- and small-vessel disease), to define different brain territories involved (strategic infarctions, cortico-subcortical and subcortical lacunes, borderzone/junctional zone infarctions, and white matter lesions) and most recently even genetics dispositions to vascular dementia of nonatherosclerotic etiology (CADASIL). Dementia caused by other mechanisms are separated from the aforementioned.