Multi Infarct Dementia - Causes, Symptoms & Treatment

Multi-infarct dementia also known is vascular dementia. Multi-Infarct Dementia is a Serious forgetfulness, mood swings, and other behavioral changes are not a normal part of aging. Vascular dementia results from brain injury caused by stroke and cerebral ischemia. Multi-infarct dementia (MID) is a common cause of memory loss in the elderly.  MID affects men more often than women. This disorder usually affects people over 55, with the average onset at age 65. MID is caused by multiple strokes (disruption of blood flow to the brain) and others causes of poor diet, lack of sleep, or too many medicines. Multi-infarct" means that multiple areas in the brain have been injured due to a lack of blood. MID affects approximately 4 out of 10,000 people. A less common cause of VaD is global hypoxic-ischemic injury. Irreversible cognitive impairment is frequently observed following coronary bypass surgery. The term dementia describes a medical condition that is caused by changes in the normal activity of very sensitive brain cells. These changes in the way the brain works can affect memory, speech, and the ability to carry out daily activities. The symptoms of MID vary. Memory loss is often an early symptom of the disorder, followed by trouble making judgments. This often progresses to delirium , hallucinations, and thinking problems. Personality and mood changes can also occur. Lack of emotion and motivation, withdrawal, and extreme excitability (agitation) are common. Confusion that occurs or is worse at night is another common symptom. Risk factors for MID include a history of stroke , hypertension , smoking, and atherosclerosis.

Multi-infarct dementia is often the result of a series of small strokes. Most common cause of vascular dementia is the blockage of small arteries supplying areas of the brain. In classical stroke, large blood vessels are blocked, resulting in the death of brain tissue supplied by that artery. The second most common cause of dementia in older adults is vascular dementia, which affects the blood vessels in the brain. A stroke occurs when blood cannot get to part of the brain. Strokes can be caused when a blood clot or fatty deposit (called plaque) blocks the vessels that supply blood to the brain. A stroke also can happen when a blood vessel in the brain bursts. Dementia associated with cerebrovascular disease is also observed in a rare genetic condition, ie, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Protocols for the evaluation and treatment of stroke are available. Medications may be required to control aggressive or agitated behaviors or behaviors that are dangerous to the person or to others.  Medications may include antipsychotics (especially the newer atypical agents, olanzapine and quetiapine), beta-blockers, and serotonin-affecting drugs such as trazodone (which may lower the blood pressure), buspirone, or fluoxetine. Acetylcholinesterase inhibitors (eg. galantamine , donepezil ) drugs work by increasing the level of a chemical (acetylcholine) within the brain of patients suffering from vascular dementia. The effectiveness of these drugs in the treatment of vascular dementia has been proven in a number of recent clinical trials.

Causes of Multi Infarct Dementia

Common causes and Risk factors of Multi Infarct Dementia

• Diabetes mellitus.
• Hypertension.
• Cardiomyopathy.
• Possibly homocysteine levels.
• Infection ( Herpes simplex encephalitis ).
• Transient global amnesia.
• Smoking.

Signs and Symptoms of Multi Infarct Dementia

Common Sign and Symptoms of Multi Infarct Dementia

• Confusion.
• Memory problems.
• Wandering.
• Bowel incontinence.
• Localized numbness or tingling.
• Swallowing difficulty. Problems handling money.

Treatment of Multi Infarct Dementia

Common Treatment of Multi Infarct Dementia

• Cholinesterase inhibitors have shown to be helpful in various randomised controlled trials. .
• Electroconvulsive therapy may be indicated in extreme cases provided. Protocols for the evaluation and treatment of stroke are available.
• Medications may include antipsychotics (especially the newer atypical agents, olanzapine and quetiapine).
• Beta-blockers, and serotonin-affecting drugs such as trazodone (which may lower the blood pressure), buspirone, or fluoxetine also useful treatment for multi infarct dememtia.
• Acetylcholinesterase inhibitors (eg. galantamine , donepezil ) drugs work by increasing the level of a chemical (acetylcholine) within the brain of patients suffering from vascular dementia.
• Patients with agitation may respond to environmental modification. Pharmacologic treatment can be useful in controlling agitation through sedation.