Vascular dementia

Changes in the brain in vascular dementia

Vascular dementia is caused by blood clots in the blood vessels of the brain. The disease can occur in all parts of the brain. Blood clots in the heart, which are formed as a result of irregular heartbeat (atrial fibrillation), or which break free from atherosclerosis of the carotid arteries, can be routed with the blood stream to one of the brain’s larger blood vessels where they can get stuck. As a result, a larger brain area is deprived of its blood supply and is destroyed (this is called an infarct). If the injury is sufficiently large or hit a critical area, it can cause dementia. If the person has more blood clots in other blood vessels in the brain, the damage will become more widespread (multi-infarct dementia).

In other cases, the small, fine blood vessels that supply the central areas of the brain (the white matter) are gradually closed. Here, the occlusion is usually not due to blood clots, but changes in the wall of the blood vessels that thicken as a result of high blood pressure or diabetes.

Where does vascular dementia affect the brain

Atherosclerosis and blood clots can affect all blood vessels in the brain. If one of the major pulmonary arteries to the brain or one of the major branches of it suddenly closes, the consequences will become similarly large with semi-lateral paralysis, perhaps abolished language function (aphasia) and often affect consciousness. If smaller areas are damaged by blood clots, neither the person nor relatives may detect that there has been a blood clot, especially if the blood clot does not cause paralysis. Gradual closure of the blood vessels due to high blood pressure or diabetes especially affects the central parts of the brain. The middle of the brain is provided by fine and long blood vessels, which are particularly vulnerable for example, to high blood pressure. In these areas, the nerve strands are intersecting and connect the individual centers of memory, language and spatial orientation. Therefore, special symptoms occur when the threads are damaged by the reduced blood supply and the communication between the centers is affected.

Characteristics of vascular dementia

Vascular dementia is the second largest group of dementia’s diseases. The symptoms are very different here as it depends on which areas in the brain are affected. There may be forgetfulness, difficulty in concentrating, language problems, and more. There may be hemiparesis and therefore difficulty walking, disturbed tactile sense or narrowing the field of vision. If the person hits in the deep structures of the brain, can become apathetic. Thinking gets slower, you get trouble concentrating when solving more complex tasks. Persons with vascular dementia often shows depressive symptoms. The emotional expression can fluctuate a lot, they might not be able to control cry or laughter, and emotional responses can emerge in situations where they do not feel sorry or happy. Unlike, for example, Alzheimer’s disease or Lewy body dementia, vascular dementia is not a neurodegenerative disease and the condition is not necessarily progressive. The symptoms of vascular dementia vary, as both the number and size of the vascular lesions, as well as the location of these, affect the symptoms and the degree of dementia. In some cases, there has been one or more strokes (apoplexies) with sudden onset, half-sided paralysis or speech impairment prior to the development of dementia. In other cases, the changes in the brain gradually occur without the occurrence of stroke. The most common cause is blood clots in the brain.

Vascular dementia cannot be cured, but we can do much to prevent the disease from getting worse. This prevention may be that the doctor prescribes blood pressure regulating, blood thinning or cholesterol lowering medication just as any diabetes should be well treated.
The risk factors are almost the same as for cardiovascular diseases. Our lifestyle affects several of the risk factors. It is important to exercise, eat healthy and avoid smoking because it both reduces the risk of cardiovascular disease and vascular dementia. If you have diabetes or high blood pressure, it is crucial to be treated.
Vascular dementia is not inherently in itself. Some of the risk factors for vascular dementia are partially hereditary, but are highly influenced by lifestyle.