If we ignore cognitive dysfunction from repeated large vessel infarcts, the following are the two key causes of vascular dementia:
- Multi-Infarct Dementia, specifically, subcortical vascular dementia causes an accumulation of microvascular disease, centrally. It is managed through vascular risk factor modification.
- Cerebral Amyloid Angiopathy causes cerebral cortical microhemorrhages and lobar hemorrhages. It is managed through blood pressure management and the avoidance/reduction of antithrombotic agents (when possible/appropriate). Amyloid stains with Congo red staining (it is "congophilic").
The whiteboard tutorial
Dementia provides an in-depth review of clinical and radiographic features of vascular dementia.