Mild cognitive deficits are predictive of dementia in small vessel disease
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文摘
Evidence of multiple “silent” lacunar infarctions is not uncommon among stroke patients submitted to neuroimaging studies. Current concept of vascular dementias refers to a cortical pattern, mainly Alzheimer's disease, and is not sufficient to allow preventive measures before the social impact of cognitive changes. Precise temporal relation is not possible in small vessel disease, the leading mechanism among vascular dementias. Systemic hypertension is the most significant risk factor for stroke. Long-standing hypertension is related to small vessel disease, both by the development of microatheroma, affecting larger penetrating arteries, as by segmental lipohyalinosis, affecting the smaller arteries, accounting for small lacunes, often “silent”. So, long-standing hypertensives remain leading candidates for “silent” lacunes. It's conceivable that “silent” lacunar lesions might produce subtle cognitive changes not sufficient to interfere in daily settings.