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ICD-10 - Vascular Dementia

[From World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Copyright, World Health Organization, Geneva, 1993.] ...

The general criteria for dementia (G1–G4) must be met.

Deficits in higher cognitive functions are unevenly distributed, with some functions affected and others relatively spared. Thus, memory may be markedly affected while thinking, reasoning, and information processing may show only mild decline.

There is clinical evidence of focal brain damage, manifest as at least one of the following:

  1. lateral spastic weakness of the limbs;
  2. unilaterally increased tendon reflexes;
  3. extensor plantar response;
  4. pseudobulbar palsy.

There is evidence from the history, examination, or tests of a significant cerebrovascular disease, which may reasonably be judged to be etiologically related to the dementia (e.g., a history of stroke, evidence of cerebral infarction).

The following criteria may be used to differentiate subtypes of vascular dementia, but it should be remembered that the usefulness of this subdivision may not be generally accepted.

Vascular dementia of acute onset

  1. The general criteria for vascular dementia must be met.
  2. The dementia develops rapidly (i.e., usually within 1 month, but within no longer than 3 months) after succession of strokes or (rarely) after a single large infarction.

Multi-infarct dementia

  1. The general criteria for vascular dementia must be met.
  2. The onset of the dementia is gradual (i.e., within 3–6 months), following a number of minor ischemic episodes.

It is presumed that there is an accumulation of infarcts in the cerebral parenchyma. Between the ischemic episodes there may be period of actual clinical improvement.

Subcortical vascular dementia

  1. The general criteria for vascular dementia must be met.
  2. There is a history of hypertension.
  3. There is evidence from clinical examination and special investigation of vascular disease located in the deep white matter of the cerebral hemispheres, with preservation of the cerebral cortex.

Mixed cortical and subcortical vascular dementia
Mixed cortical and subcortical components of the vascular dementia may be suspected from the clinical features, the results of investigation (including autopsy), or both.
Other vascular dementia
Vascular dementia, unspecified

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