Neurological findings

Frequent neurological findings indicating focal brain lesion early in the course of vascular dementia include mild motor or sensory deficits, decreased co-ordination, brisk tendon reflexes, Babinski's sign, visual field loss, bulbar signs including dysarthria and dysphagia, extrapyramidal signs (mainly rigidity and akinesia), disordered gait (hemiplegic, apraxic-ataxic, or small-stepped), unsteadiness, unprovoked falls, and urinary frequency and urgency. (3 3 3Z38 and 39> Features that make the diagnosis of vascular dementia uncertain or unlikely include absence of focal neurological signs, other than cognitive disturbance. (39

In cortical vascular dementia, typical clinical features are lateralized sensorimotor changes and abrupt onset of cognitive impairment and aphasia, and in subcortical vascular dementia disease pure motor hemiparesis, bulbar signs, and dysarthria. (3!'

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