Changes in the brain

Vascular dementia is related to both ischaemic and non-ischaemic changes in the brain. ty.5,,1.,14) The ischaemic lesions include arterial territorial infarct, distal field (watershed) infarct, lacunar infarct, ischaemic white-matter lesions, and incomplete ischaemic injury. Incomplete ischaemic injury incorporates laminar necrosis, focal gliosis, granular atrophy, and incomplete white-matter infarction.(2,22) In addition, both focal (around the ischaemic lesion) and remote (disconnection, diaschisis) functional ischaemic changes relate to vascular dementia, and the volume of functionally inactive tissue exceeds that of focal ischaemic lesions in vascular dementia.(23) Limitation in current clinical methods have hampered the detection of both incomplete ischaemic injury and functional ischaemic changes related to vascular dementia. Atrophy is the non-ischaemic factor related to vascular dementia. However, there are no methods to distinguish between ischaemic and degenerative causes of atrophy.

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