Book Review: Subcortical Vascular Dementia

The featured book is ‘Subcortical Vascular Dementia’ Edited by Rita Moretti.There are sixteen chapters with each having a single author or else a combination of the names given in the reference below. This edition was a hardback with a number of colour illustrations throughout the book. The introduction is fairly brief focusing on the broader concept of vascular dementia and is quite factual with no introduction to the contributors or the reasons for writing the book. The first chapter is on the anatomy and physiology of the cerebral blood supply and this curiously contains a number of diagrams of the brain with pointing lines but no labels.  The authors then describe the cerebral venous drainage while at the same time stating that this will not be mentioned again as the focus is on the arterial supply. There is very little information on the arterial supply (I checked to see if there were pages missing but the pagination didn’t indicate so). There is then coverage of stroke mechanisms and pathophysiology including cellular and immune changes that occur following a stroke.

The next chapter considers cerebrovascular disease and cognition in the elderly and focuses on changes in a few areas of the brain and their associations with cognitive changes. Chapter three focuses on cerebrovascular disease and dementia and is a very good chapter with some particularly interesting discussion around diagnostic difficulties. Chapter four is on Subcortical Vascular Dementia itself and covers pathology and risk factors. Haemodynamic changes are covered in the next chapter where we learn of the importance of hypotension in addition to hypertension. A chapter on neuropsychology looks in detail at some of the research that the authors have undertaken in this area and in the subsequent chapter there is a focus on behavioural changes although in my opinion this is simply a misclassification – the terms ‘depression’ an ‘insight’ are not behaviours but instead relate to phenomenological experiences. There then follows a chapter on radiotherapy associated dementia where cerebrovascular sequalae may follow and they hypothesise that problems arise because of an interference with frontal cortical-subcortical loops (which might be relevant for subcortical vascular dementia). This is followed up in the next chapter where the anatomy of the frontal subcortical-cortical pathways are considered in more detail. Neuroimaging and vascular dementia is another very interesting chapter with a detailed theoretical understanding of the pathological changes informing how imaging might be used effectively in the diagnostic work-up. There then follows an examination of some of the therapeutic options with promising results for Rivastigmine in Subcortical Vascular Dementia discussed.

The strength of this book is that Moretti has initiated work in a relatively unexplored area and by assembling the team of contributors has established a structure on which to build. There are some recommendations for future directions in research and development throughout the book and it would be interesting to see a subsequent revision of the book when more material on subcortical vascular dementia is available (as opposed to the broader concept of vascular dementia) as well as a development of some of the actions the authors have suggested.

References

Rita Moretti (Ed). Subcortical Vascular Dementia. Nova Science Publishers Inc. 2006. Contributors – Rodolfo Antonello, Giuseppe Bellini, Elena Bernobich, Tatiana Cattaruzza, Amos Korczyn, Rita Moretti, Gilberto Pizzolato, Paola Torre, Maja Ukmar, Cristina Vilotti.

Responses

If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk

Disclaimer

The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

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