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Stroke-Related Dementia

Facts on Stroke-Related Dementia

Stroke (“brain attack”) is a disease of the blood vessels in and around the brain. It occurs when part of the brain does not receive enough blood to function normally and the cells die (infarction), or when a blood vessel ruptures (hemorrhagic stroke). Infarction is more common than hemorrhage and has a number of causes; for example, a vessel (artery) supplying blood to the brain can become blocked by a fatty deposit (plaque), which can form clots and send pieces into vessels further in the brain, or these arteries become thickened or hardened, narrowing the space where the blood flows (atherosclerosis). In addition, clots can arise in the heart and travel to the brain. Permanent damage to brain cells can result.

The symptoms of stroke vary, depending on which part of the brain is affected.

  • Common symptoms of stroke are sudden paralysis or loss of sensation in part of the body (especially on one side), partial loss of vision or double vision, or loss of balance. Loss of bladder and bowel control can also occur.
  • Other symptoms include decline in “cognitive” mental functions such as memory, speech and language, thinking, organization, reasoning, or judgment.
  • Changes in behavior and personality may occur.
  • If these symptoms are severe enough to interfere with everyday activities, they are called dementia.

Cognitive decline related to stroke is usually called vascular dementia or vascular cognitive impairment to distinguish it from other types of dementia. In the United States, it is the second most common form of dementia after Alzheimer's Disease. Vascular dementia is preventable, but only if the underlying vascular disease is recognized and treated early.

People who have had a stroke have a 9 times greater risk of dementia than people who have not had a stroke. About 1 in 4 people who have a stroke develop signs of dementia within 1 year.

Vascular dementia is most common in older people, who are more likely than younger people to have vascular diseases. It is more common in men than in women.

What Causes Stroke-Related Dementia?

Vascular dementia is not a single disease but a group of conditions relating to different vascular problems. What all the conditions have in common is that a critical part of the brain does not receive enough oxygen. The vascular damage underlying stroke-related dementia occurs in several different patterns.

  • Multi-infarct dementia - Occurs after a series of strokes in different parts of the brain
  • Single-infarct dementia - Occurs when one large vascular lesion causes a severe infarction, or there is a single infarction in a strategic area of the brain
  • Dementia due to lacunar lesions - Occurs when only the smaller arteries are affected, causing multiple small infarctions
  • Binswanger disease - Also a disease of small arteries, but the damage primarily occurs in the white matter area of the brain
  • Dementia due to hemorrhagic (bleeding) stroke - Occurs when a blood vessel bursts causing bleeding in the brain

The major cause of the vascular lesions underlying stroke-related dementia is untreated high blood pressure (hypertension). Diabetes, atherosclerosis (“hardening of the arteries”), heart disease, high cholesterol, peripheral vascular disease, and smoking are other risk factors. Other causes include uncommon vascular diseases.

Vascular dementia may occur with Alzheimer's Disease. ApoE4 is a protein whose main role is to help transport cholesterol in the blood. A high level of this protein in the blood poses a significant risk factor for Alzheimer dementia and has been linked to vascular dementia.

Medically Reviewed by a Doctor on 11/14/2016
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