Prevention and treatment for vasucular cognitive impairment due to small vessel disease

Yasumasa Yamamoto¹⁾, Yoshinari Nagakane²⁾, Yasuhiro Tomii¹⁾

¹⁾Kyoto Katsura Hospital, Department of Neurology
²⁾Kyoto Second Red Cross Hospital, Department of Neurology

Vascular dementia (VaD) due to small vessel diseases (VD-SV) is the commonest form of VaD in Japan. Binswanger's disease (BD) represents an advanced subtype of VD-SV, which consists with hypertensive lipo- and fibrohyalinosis of cerebral small vessels that leads to diffuse white matter lesions (DWML) and multiple lacunes. Hypertension, especially nighttime hypertension, is a major risk factor for VD-SV. Reducing the activity of renin-angiotensin-aldosterone system, as well as additional use of small amount of diuretics, may help to control high night time blood pressure. Phosphodiesterase inhibitor may also help ameliorate cerebral circulation leading to halt the progressive VD-SV.

Address correspondence to Dr. Yasumasa Yamamoto, Kyoto Katsura Hospital, Department of Neurology(17 Yamada Hiraocho, Nishikyoku, Kyoto 615-8256)