Valencia C, Marti-Fàbregas J, Belvis R, Martí-Vilalta J L
Unidad de Enfermedades Vasculares Cerebrales, Servicio de Neurología, Hospotal de la Santa Creu i Sant pau Universitad Autónoma de Barcelona, Spain.
Neurologia. 2003 Apr;18(3):149-57.
Advance in the health care systems, in medical knowledge and improvements in quality of life have contributed to the fact that life expectancy of the persons in developed countries exceeds 80 years of age. This has made it possible to observe the increase in frequency of common diseases of the elderly, one of the most relevant of which is dementia. The two most frequent etiologies of dementia are the degenerative one, with Alzheimer's disease (AD) as the main cause, and those of vascular etiology or vascular dementia, within which subcortical arteriosclerotic encephalopaty or Binswanger's disease (BD) are found with low prevalence. Since, on one hand, diagnosis of the dementias is not enough or definitive by clinical means, and on the other hand, the pathological diagnosis does not modify the evolution of disease, emphasis is presently placed on diagnosis by neuroimaging studies. In recent years, with the coming of the computerized tomography (CT) and the magnetic resonance (MR), it has been possible to observe lesions in the white matter of the brain hemisphere in patients with these two etiologic groups of dementias, that is, degenerative and vascular, as well as in elderly patient without cognitive deterioration, with or without vascular risk factors.
医疗保健系统的进步、医学知识的发展以及生活质量的提高，使得发达国家人们的预期寿命超过了80岁。这使得人们能够观察到老年人常见疾病的发病率上升，其中最相关的疾病之一是痴呆症。痴呆症最常见的两种病因，一种是退行性病因，以阿尔茨海默病（AD）为主要原因；另一种是血管性病因或血管性痴呆，其中皮质下动脉硬化性脑病或宾斯旺格病（BD）的患病率较低。一方面，由于痴呆症的临床诊断并不充分或具有决定性，另一方面，病理诊断并不能改变疾病的发展进程，因此目前重点在于通过神经影像学研究进行诊断。近年来，随着计算机断层扫描（CT）和磁共振成像（MR）的出现，已经能够观察到这两种病因类型的痴呆症患者，即退行性和血管性痴呆症患者，以及无认知功能减退的老年患者（无论有无血管危险因素）脑半球白质中的病变。
