The significance of microcirculatory disturbances in the pathogenesis of vascular dementia.

Cerebral microangiopathies based on arteriosclerosis are frequent. In most cases, microangiopathy is the result of long standing hypertension. Other risk factors, however, such as diabetes mellitus or disturbances of fatty metabolism, may also be responsible. The sequels of cerebral microangiopathy can be lacunar infarcts or subcortical arteriosclerotic encephalopathy. Both status lacunaris and subcortical arterioslerotic encephalopathy can result in development of dementia if they last for a long time. Particularly in these disorders, however, it is imperative to carry out preventive measures by influencing the vascular risk factors. Another approach to therapy is offered by influencing the haemorrheological properties of the blood by means of vasoactive preparations.