title: Microembolism, silent brain infarcts and dementia.
abstract: Cognitive decline becomes more prevalent than ever in parallel with the increasing life expectancy of the population. Alzheimer' disease (AD) and cerebral vascular lesions are common in the elderly and represent, with increased age, the most frequent contributors to cognitive decline. It is now believed that these pathologies frequently coexist in the same brain. The border discriminating vascular dementia from AD is blurred and challenges our understanding of these clinical entities. Further research, at both basic and clinical levels, is mandatory in order to better understand the interactions of vascular ischemic injury and primary degenerative physiopathologies of the brain, in order to prevent and better manage patients with cognitive decline. We review recent published clinical evidence of silent brain ischemia as a contributor to cognitive decline and dementia. Microemboli, from both cardiac and vascular origins, have been shown to be associated with structural changes in the brain. The role of transcranial Doppler as an objective tool for detecting and quantifying microemboli is discussed in light of recent clinical evidence.
authors.affiliation: Department of Neurology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel. ilan.goldberg@gmail.com
authors.forename: I
authors.initials: I
authors.lastname: Goldberg
authors.forename: E
authors.initials: E
authors.lastname: Auriel
authors.forename: D
authors.initials: D
authors.lastname: Russell
authors.forename: A D
authors.initials: AD
authors.lastname: Korczyn
mesh_terms: D001921:Brain / Q000473:pathology*; D020520:Brain Infarction / Q000150:complications* / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D003704:Dementia / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D018608:Ultrasonography, Doppler