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Stroke-Related Dementia

Stroke (also called a "cerebrovascular accident," or CVA) is a disease of the blood vessels in and around the brain. It occurs when part of the brain does not receive enough blood to function normally (called "ischemia") and the cells die (infarction), or when a blood vessel ruptures (hemorrhagic stroke). Ischemia is more common than hemorrhage and has a number of causes: a vessel (artery) supplying blood to the brain can become blocked by a fatty deposit (plaque), which can form clots and send pieces into vessels further in the brain, or these arteries become thickened or hardened, narrowing the space where the blood flows (atherosclerosis). In addition, clots can arise in the heart (called a "thrombus") and travel to the brain (called an "embolus"). Permanent damage to brain cells can result.

The symptoms of stroke vary, depending on which part of the brain is affected.

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A year ago last October I got up at 4 a.m., went to the bathroom, and came back to bed -- and all of a sudden everything started spinning. I got up and fell back down. I had blurry and double vision. I was extremely nauseous and vomited for hours. It crossed my mind that I might be having a stroke -- I've been a stroke nurse practitioner for 8 years -- but I thought, this is too ironic. I'm 44. I'm healthy. I have no known risk factors. I don't have high blood pressure, high cholesterol, or diabetes...

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  • Common symptoms of stroke are sudden paralysis or loss of sensation in part of the body (especially on one side), slurred speech, partial loss of vision or double vision, or loss of balance. Loss of bladder and bowel control can also occur.

  • Other symptoms include decline in "cognitive" mental functions such as memory, speech and language, thinking, organization, reasoning, or judgment.

  • Changes in behavior and personality may occur.

  • If these symptoms are progressive and severe enough to interfere with everyday activities, they are called dementia or "major neurocognitive disorder."

Cognitive decline related to stroke is usually called vascular dementia or vascular cognitive impairment to distinguish it from other types of dementia. In the United States, it is the second most common form of dementia after Alzheimer's disease. Vascular dementia may be preventable, but only if the underlying vascular disease (such as hypertension) is recognized and treated early.

People who have had a stroke have a far greater risk of developing dementia than people who have not had a stroke. About 1 in 4 people who have had a stroke develop signs of dementia within 1 year.

Vascular dementia is most common in older people, who are more likely than younger people to have vascular diseases. It is more common in men than in women.

WebMD Medical Reference from eMedicineHealth

Reviewed by Joseph Goldberg, MD on April 22, 2014

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