Stroke: A Potential Risk Factor of Neurodegenerative Disorders

Stroke: A Potential Risk Factor of Neurodegenerative Disorders

Carlos Henrique Ferreira Camargo (Hospital Universitário dos Campos Gerais – UEPG, Brazil), Mariana M. Canever (Federal University of Paraná, Brazil), Valeria Cristina Scavasine (Federal University of Paraná, Brazil) and Marcos Christiano Lange (Federal University of Paraná, Brazil)
DOI: 10.4018/978-1-5225-5282-6.ch007

Abstract

The brain relies on a specialized endothelial system, the blood brain barrier (BBB), which is capable of regulating the transfer of substances from the blood to the neurons. Stroke is the most frequent cause of disability in adulthood. Lesions of vascular origin also include asymptomatic small infarcts, microbleeds, dilated perivascular spaces, and atrophy. Vascular cognitive impairment (VCI) is the second most prevalent cause of dementia. Several mechanisms are implied, including strategic infarct dementia, post-stroke dementia, cerebral amyloid angiopathy, and subcortical vascular dementia. As there is no disease modifying therapies currently available, treatment of comorbidities and adequate control of the vascular risk factors remain the standard strategies to reduce the vascular contributions to neurodegeneration. This chapter represents the basic concepts of pathophysiology of cerebrovascular diseases, and describes the subtypes of VCI, as well as treatment and primary prevention strategies.
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Background

The attempt to divide normal ageing from pathological senility began in the late 19th century, which was a critical period for developing the concept of dementia as we know it today. At that time, the definition of dementia was similar to the one used nowadays, although much more inclusive: a general compromise of intelligence, with prominent memory loss and alterations of personality. Studies by French and German psychiatrists were crucial to separate psychotic syndromes, such as schizophrenia, from other forms of cognitive impairment. This interest in understanding pathological aging has encouraged a great number of histological studies, which helped divide organic and psychiatric diseases into different nosological entities (Caixeta et al., 2014).

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