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Psycology » Psychiatry and psychotherapy » Vascular disease of the brain » Vascular dementia

  1. Vascular disease of the brain
  2. Vascular dementia
  3. Leukoencephalopathy
  4. Vascular psychosis
  5. Etiology, diagnosis and treatment of mental disorders vascular

Vascular dementia (dementia) is the main syndrome in development of severe atherosclerosis and hypertension (these types of vascular pathology often combined). Dementia often develops in people who have had a stroke. According to JE Rakhalsky, incidence of stroke in the history of patients with atherosclerotic dementia is 70.1%.

Vascular dementia as a special quality pathological state is formed due to the gradual (or rapid) growth amnestic disorders, stiffness, rigidity of thought, affect incontinence. In the presence of vascular strokes during the process becomes jerky.

Classical type of vascular dementia is considered a "lacunary" partial dementia, which is characterized by uneven lesions of various aspects of the psyche and intellect with an increase in memory disorders and selective reproduction violation chronological orientation (while there is relative safety and allopsihicheskoy autopsihicheskoy orientation). Progressing difficulty and slowing down of all mental processes. Observed asthenia and anergasia, difficulty of speech communication, difficulty in finding the right words, the decline in judgment and criticism with a certain safety consciousness of worthlessness and fundamental attitudes, (save the "core personality"). With almost constant symptoms are tearful mood, slabodushie. This type of dementia develops in atherosclerotic processes manifesting in age from 50 to 65 years. In some cases, it may be formed gradually, due to increased psychoorganic disorders encountered in the early stages of the disease. In some patients, lacunar dementia syndrome occurs more acutely (postapoplektiformnaya dementia). In such cases, the onset of dementia is preceded by a transition (within the meaning of X. Vic) amnesic, korsakovopodobny syndrome.

After an acute cerebrovascular accident (stroke, severe hypertensive crises, subarachnoid hemorrhage), and sometimes after acute vascular psychoses possible offensive amnesic syndrome with severe dementia memory type fixation amnesia, disorientation and confabulation rough. Painting of the amnestic dementia in some cases reversible and is described X. Vaytbreht painting "acute dementia."

Altsgeymeropodobny type of vascular dementia (dementia asemicheskoe) is characterized by manifestations of focal cortical brain disorder that is associated with a particular vascular localization process. Similar types of dementia previously designated as a disease VM Gakkebush, TA Geyer, AI Geymanovicha (1912). These researchers believed that the clinical picture similar locally affects the small vessels of the brain (atherosclerosis smallest capillaries) occurs simulation conditions that characterize Alzheimer's disease. Later cases have been described in the works of AB Snezhnevsky (1948), EY Sternberg (1968) with reference to the second phenomenon developing senile brain atrophy. For such patients, characterized by a more acute onset and observed as the "flicker" symptoms (described G. Shtertsem). Possible nightly observed for a few hours, psychotic episodes, atypia focal symptoms that allows you to diagnose vascular process.

Psevdoparalitichesky type of vascular dementia characterized by symptoms that looks like a picture of a progressive paralysis. In these patients, there is a combination of dementia with euphoria or expansively-mania with the prevalence of general carelessness, talkativeness, disinhibition and loss drives critics sharply reducing judgment, memory, orientation. Psevdoparalitichesky type of vascular dementia is often found in younger patients (under 65 years) with severe hypertensive encephalopathy or frontal localization of softening of the brain.

In severe hypertensive encephalopathy and sometimes found a rare form of vascular dementia patients with stunning, weakness and decreased motor and speech activity expressed difficulty in fixing the attention, perception and understanding what is happening. Because of the similarity of symptoms with such paintings, developing brain tumors, these conditions are defined as "pseudotumor."

Senilnopodobny type of vascular dementia develops in the process of manifestation of vascular age (after 70 years). As in cases of senile dementia, the initial stage of this type of vascular dementia characterized by personality changes expressed incredulity, dissatisfaction, grumbling, irritable, hostile attitude towards others. The clinical picture of dementia characterized by deeper and more diffuse impaired memory than it is expressed at dismnesticheskom dementia. Patients sharply expressed disorientation and signs "shift the situation in the past," says deeper decline all kinds of mental activity. This indicates that the dementia is more reminiscent of the "total of dementia", but at the same time, it is not as catastrophic as in senile dementia.


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