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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.
Clinical depression goes by many names -- depression, "the blues," biological depression, major depression. But it all refers to the same thing: feeling sad and depressed for weeks or months at a time (not just a passing blue mood), accompanied by feelings of hopelessness, lack of energy, and taking little or no pleasure in things that gave you joy in the past.
Psychiatrists estimate that one in four women and one in ten men can expect to develop depression during their lifetime; depression affects at least one in 50 children under 12 and one in 20 teenagers.
Symptoms
Generally, the symptoms of depression include:
&bullFeeling sad, hopeless and despairing
&bullA loss of interest and pleasure in normal activities
&bullLoss of appetite or weight
&bullLoss of sex drive
&bullSleeping problems, such as an inability to get to sleep or early waking
Types of Depression
Psychotic Depression:
Sufferers of psychotic depression begin to hear and see imaginary things - - sounds, voices and visuals that do not exist. These are referred to as hallucinations, which are generally more common with someone suffering from schizophrenia. The hallucinations are not "positive" like they are with a manic depressive. The sufferer of psychotic depression imagines frightening and negative sounds and images.
Melancholic Depression
Is a more severe depression than non-melancholic depression and is primarily caused by biological factors. It is an uncommon type of depression, affecting only around 1-2% of the population and roughly the same number of males and females. It can occur on its own (unipolar) or as part of Bipolar Disorder.
Major Depression
An individual with major depression feels a profound and constant sense of hopelessness and despair.
Major depression is manifested by a combination of symptoms that interfere with the ability to work, study, sleep, eat and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.
Cyclothymic disorder
Cyclothymic disorder is when a person has mild and alternating mood swings of elation and depression occurring over a long time period. Because the mood swings are mild, and the elation is often enjoyable, frequently people with cyclothymic disorder do not seek medical help.
The periods of elation and depression can last for lengthy periods, such as a few months. Often, a person with cyclothymic disorder has a relative with bipolar disorder, or they may develop bipolar disorder themselves.
Psychotic depression -
A depressed mood which includes symptoms of psychosis. Psychosis involves seeing or hearing things that are not there (hallucinations), feeling everyone is against you (paranoia) and having delusions.
Non-melancholic - in this case the depression is not melancholic, or, put simply, not primarily biological. Instead, it has to do with psychological causes, and is very often linked to stressful events in a person's life, alone, or in conjunction with the individual's personality style.
Non-melancholic depression is the most common of the three types of depression. People with non-melancholic depression experience:
&bulla depressed mood for more than two weeks
&bullsocial impairment