How can cerebral infarcts and hemorrhages lead to dementia?
The incidence of new onset dementias is increased after stroke. The objective of this review is to investigate how cerebral infarcts and hemorrhages can lead to dementia. Stroke subtypes, total volume of cerebral lesion and functional tissue loss, and location of the lesions are the major determinant of dementia in stroke patients. The causal relationship between stroke and dementia is clear: (1) in young patients who are unlikely to have associated Alzheimer pathology; (2) when the cognitive functioning was normal before stroke, impaired immediately after, and does not worsen over time; (3) when the lesions are located in strategic areas; and (4) when a well-defined vasculopathy known to be associated with dementia is proven. However, white matter changes and associated Alzheimer pathology may also contribute to the dementia syndrome in stroke patients.
Leys
D
D
Department of Neurology, Stroke Department, Lille University Hospital, Lille, France.
Pasquier
F
F
D001921:Brain / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000523:psychology*; D002544:Cerebral Infarction / Q000523:psychology*; D003704:Dementia / Q000209:etiology* / Q000473:pathology; D006801:Humans; D012307:Risk Factors; D020521:Stroke / Q000523:psychology