Erkinjuntti T
Department of Neurology, University of Helsinki, Finland.
Dementia. 1994 May-Aug;5(3-4):189-92. doi: 10.1159/000106721.
Vascular dementia (VAD) is the second most common cause of dementia. In addition, cerebrovascular disease (CVD) coexists with other causes, including Alzheimer's disease. Cognitive impairment related to CVD may be preventable, and these patients could benefit from therapy. This emphasizes the need for early detection, diagnostic consistency and accuracy of the clinical diagnosis of VAD. A number of current limitations in our knowledge about VAD have restricted the construction of clinical criteria, especially the concept of a behavioral syndrome due to vascular factors affecting the brain, and the main pathophysiological factors related to VAD. The latter include the type, extent, location and tempo of vascular brain lesions, as well as the causality between brain lesions and cognitive impairment. However, relevant information on VAD is beginning to emerge. The NINDS-AIREN Workshop on VAD made an attempt to facilitate international discussion and cooperation by defining consequences of CVD and the criteria for the VAD syndrome, for epidemiological and clinical studies. Here the concepts, pathophysiological factors, current conceptual barriers, and the criteria for the clinical diagnosis are reviewed.
血管性痴呆（VAD）是痴呆的第二大常见病因。此外，脑血管疾病（CVD）与包括阿尔茨海默病在内的其他病因并存。与CVD相关的认知障碍可能是可预防的，这些患者可能从治疗中获益。这凸显了早期检测、诊断一致性以及VAD临床诊断准确性的必要性。目前我们对VAD认识的一些局限性限制了临床标准的构建，特别是由于影响大脑的血管因素导致的行为综合征概念，以及与VAD相关的主要病理生理因素。后者包括脑血管病变的类型、范围、位置和进展速度，以及脑病变与认知障碍之间的因果关系。然而，有关VAD的相关信息正开始显现。NINDS - AIREN关于VAD的研讨会试图通过定义CVD的后果以及VAD综合征的标准来促进国际讨论与合作，以用于流行病学和临床研究。在此对相关概念、病理生理因素、当前概念障碍以及临床诊断标准进行综述。
