engleski

Vascular dementia - a case report

We present a patient with vascular dementia. In clinical practice, the main issue is to evaluate the type of dementia from which a patient is suffering, and to set differential diagnosis between Alzheimer, vascular and other types of dementias as earliest as possible. Our patient suddenly developed a cerebrovascular ischemia at the age of 68. The computed brain tomography, and the magnetic resonance brain imaging confirmed an ischemic area in the temporoparietal subcortical region of the right brain hemisphere, which was clinically presented as a mild left-side hemiparesis improving quite quickly in time. Atrial fibrillation, arterial hypertension and moderate atherosclerotic changes on the carotid bifurcations bilaterally were present as vascular risk factors. The cognitive dysfunction appeared several days after the stroke and became a dominant symptom. The patient had hallucinations, total disorientation in space and time, did not recognize family members. After administering donepezil, as well as antipsychotics, there was an improvement. After two years of treatment, the patient showed no cognitive decline by using MMSE, but success on the Dementia Rating Scale was under the critical limit, especially on the subscales concerning construction ability and preservation. The Clock Drawing Test also confirmed mild visuo-spatial mistakes. It is necessary to follow up on the cognitive impairment not only by using MMSE, but also by using DRS and CDT. The clinical onset of the vascular accident and good recovering by using acetilcholinesterase inhibitors suggests vascular dementia.

Stroke; Cerebrovascular disease; Vascular dementia

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