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.