Doctor insights on:
Multi Infarct Dementia In Children
Many small strokes: Multiple small "lacunar infarcts" can add up and create a picture very similar to alzheimers, and result in significant cognitive problems. Need to treat the dementia with meds, but also prevent further strokes with meds. Complex, so need fairly thorough evaluation and treatments. ...Read more
When the blood supply of a tissue is compromised by whatever mechanism, the tissue will stop working and if blood flow is not restored, the tissue will eventually die ("infarct", both verb and noun). The clinical picture that runs with development of an infarct ("heart attack"; ...Read more
Thorough Evaluation: Tests determine whether other medical problems could be causing dementia, such as anemia, brain tumor, chronic infection, drug and medication intoxication, severe depression, thyroid disease, vitamin deficiency. Neuropsychological testing is helpful to find out what parts of thinking have been affected, and to guide other tests. Tests also can include a head ct scan and MRI of the brain. ...Read more
See below: The safety needs of the patient need to be assessed based on the stages of dementia. This process is continuous. If patient is still at home, home visits should be made to ensure that there is enough food, medication is taken on time, the environment is safe. If person is at the nursing facility, usually facilities have protocols in place to ensure the safety of the patient. ...Read more
Due to strokes: "dementia" is loss of cognitive faculties to less than a person's previous baseline leading to an inability to function independently. "multi-infarct" means multiple strokes, usually caused by blockage of circulation in discrete areas of the brain resulting in dead brain cells and/or their connections to other brain cells. Multi-infarct dementia may be patchy in what works and what doesn't. ...Read more
Two things:: First and foremost, control the underlying contributing factors to the strokes, ie: the high blood pressure or cholesterol or smoking, etc. Secondly is to treat the dementia by increasing acetylcholine in the brain with aricept, etc and to decrease glutamate with namenda (memantine). ...Read more
Stroke is: The cause of multi-infarct dementia. Management is to prevent other strokes from occurring. See doctor regularly to keep blood pressure, cholesterol and diabetes (if you have it) under good control. If abnormal heart rhythm (atrial fibrillation) is present, then would need blood thinner to prevent blood clots in heart which can lead to stroke. ...Read more
See below: Poor safety awareness is due to poor insight, judgment and planning. This person may have a lack of initiation before doing anything. Perhaps a neuropsychological evaluation or geriatric assessment would be helpful. ...Read more
Piracetam: No. Piracetam was one of the first drugs used for dementia and comes from the class of drugs called nootropics, whose actions are still poorly defined. Most of the trials of piracetam were undertaken many years ago and did not use methods which would be currently considered standard. Some of the studies suggested there may be some benefit from piracetam but overall the evidence is not consistent. ...Read more
I have been told I have mild ectasia of the basilar artery. I suffer with migraine and my father has multi infarct dementia. Should I be concerned?
Multi infarct stroke dementia patient, will stopping ssri antidepressant have a negative impact after some time and patient has shown improvement? Is it addictive or have a downer. Any ALT antidep's?
Vascular dementia: These days multi infarct dementia is referred to as vascular dementia. After a stroke there is evidence that ssri antidepressants help prevent post stroke depression. There is a little but not a lot of evidence that ssris help those with vascular dementia. Ssris are not addictive. For specific advice about using any antidepressant it would be best to see a mental health expert. ...Read more
What specifc therapy can be given to multi infarct stroke dementia patient, 67, to improve cognitive functions and part memory loss. Also need tips for the caregiver to understand the patients needs?
Support groups: A support group for caregivers of dementia patients or alzheimer's patients can be very helpful. There you can find out from others what their troubles have been and what they have tried. The alzheimer's association or the alzheimer's foundation of america have good online websites with information that often applies to all types of dementia including multiinfarct or vascular dementia. ...Read more
What tests can we do to check effect of dabigatran on patient with heart problems, multi infarct stroke dementia? Recently moved to d'tran from warfarin after stroke. Any interaction with antideprests
Are there any non standard or special new treatments for multi infarct stroke dementia patient with loss of memory, cognitive functions?
No: At the present time, there is no new or novel treatment in patients who already had a stroke. There is only prevention of future strokes. ...Read more
Will ssri antidepressants work to improve cognitive functions and memory loss of a recent multi infarct stroke dementia patient, age 67. How long should he take them until we see an improvement?
Possibly: Depending on the level, location, severity of the vascular lesions or cerebral insults, there is a possibility that some sxs will be reversed somewhat or improved; the brain can compensate at times for vascular insults; however, the key element is treating the underlying diseases such as hypertension and weight and removing high risk behaviors such as smoking. ...Read more
Can be hard to know: If dementia occurs in the context of cerebrovascular disease (strokes, tias), especially if the deficits correlate with known anatomical lesions, it is presumed vascular. Neuropsych testing may add evidence (or not). Vascular dementia also tends to progress in discrete steps, rather than continuously. There are many causes of dementia; some can be hard to diagnose in the living patient. ...Read more
Vascular dementia: There are two common reasons - the first is related to not stopping or being able to reverse the vascular damage that has occurred. Often people have uncontrolled hypertension or inflammatory changes that go unchecked. The second reason is that aging does alter other functions in the brain, including health of blood vessels and neurons and supporting cells. Adds to deficits. ...Read more
Vascular dementia: Vascular dementia may overlap with other types of dementia such as alzheimer's, but results from damage to, or blockages in, blood vessels that nourish the brain. This leads to tiny "infarcts" or deaths of nerve cells in the brain. People with hypertension and/or arteriosclerotic narrowing of these blood vessels are vulnerable to such changes, which happen in a stair-step process over time. ...Read more
Not helpful: Vascular dementia is caused by multiple strokes, usually each fairly small, and best to protect with an anti platelet drug, such as clopidigrel, or aggrenox. But, many older pts also, have mixed dementia, alzheimer's plus vascular problems. Symptomatic relief may require galanttamine or donepezil. ...Read more
Depends: A large stroke can lead to vascular dementia and if you had one stroke you are at high risk of having another. Alzheimer's has a more predictable progression in general but everyone is unique so generalizations are difficult. ...Read more
Not easy: Clinically, alzheimer's tends to be a smooth decline over time, while vascular dementia declines in steps, as small regions of the brain lose function. Neuropsychological testing may lend evidence for, but not prove, one cause or the other. A definitive diagnosis can only be made by brain biopsy (which is rarely done), or at autopsy. ...Read more
My grandmother has vascular dementia does anybody know what behavioral difference is between this and alzheimers?
Can be quite similar: Vascular dementia causes deficits in the areas of the brain affected by stroke. Alzheimers disease causes problems with memory, language, making decisions, planning multistep tasks. And gradual decline in functioning. Behavioral symptoms - hallucinations, delusions, depression, anxiety, agitation, aggression, irritability, disinhibition, apathy, can occur with both illnesses. Some folks have both. ...Read more
Briefly,: Ad progresses slowly, but it does progress. Vd occurs suddenly and stabilizes. With additional incidents, it again abruptly worsens, then stabilizes. Depending on the site of the damage, motor function will or will not be involved. Ad may take a long time to effect motor ability. It's a bit like "disease vs injury". Below is a link since 400 chars is too little. Hope it helps. ...Read more
Step down process: Vascular dementia is caused by poor circulation to parts of the brain caused by ongoing "mini-strokes" that occur. Alzheimer's dementia is a chronic gradual decline, whereas vascular dementia can have sudden decreases in physical and cognitive functioning. Like walking down the stairs. They may be stable, sharp decline, stable, sharp decline etc. ...Read more
Variable picture: Vascular dementia is the result of pathological changes in the blood vessels of the brain that leads to decrease or total interruption blood supply to parts of the brain. The sufferer may never have a stroke or tia. The deficits are usually due to changes in small vessels. The symptoms and progression are variable. Prevention depends on managing vascular risk factors. Hope this helps. ...Read more