Biochemical diagnosis of vascular cognitive impairment associated with subcortical small vessels disease.

Biochemical diagnosis of vascular cognitive impairment associated with subcortical small vessels disease. Hell J Nucl Med. 2019 Jan-Apr;22 Suppl:187-193 Authors: Liakakis G Abstract Subcortical small-vessel disease (SSVD) is a disorder that has been fully described in clinical, neuropathological and imaging aspects. It is considered as the most prevalent ischemic CNS disorder and has been associated to arterial hypertension, diabetes mellitus, dyslipidemia and obstructive sleep apnea. The hallmark of SSVD is the ischemic white matter lesions which can be presented as lacunar infracts and global brain hypoperfusion in a common and homogeneous subtype of vascular cognitive impairment (VCI) which is often unrecognized. The special nature and course of SSVD offers the opportunity of collecting knowledge at all stages of its pathogenicity. Arteriosclerosis, hypoxic hypo-perfusion and inflammation act synergistically, causing myelin degeneration and blood brain barrier alteration. Clinical diagnosis of SSVD includes early executive dysfunction manifested by impaired capacity to use complex information, to formulate strategies, and to exercise self-control. Brain imaging has advanced substantially the diagnostic tools for SSVD. Diagnostic biomarkers for Alzheimer Disease include reduction of cerebrospinal fluid amyloid-β (Aβ)42 and of the ratio Aβ42/Aβ40 sometimes with increased total tau levels. However, biomarkers specific for the diagnosis...
Source: Hellenic Journal of Nuclear Medicine - Category: Nuclear Medicine Tags: Hell J Nucl Med Source Type: research

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CONCLUSION: Glucocorticoids is the the mainstay of treatment. Therenal function tests, of the vast majority of patients, normalizedwith treatment. Relapse may occur, so a follow-up over a longperiod of time is required. A high index of suspicion is neededfor diagnosis in asymptomatic patients. PMID: 31422391 [PubMed - in process]
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Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
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