[Dementia and stroke: the importance of coexisting brain pathologies]

In this paper we present evidence to support the idea that vascular and degenerative pathological processes interact synergically in the genesis of post stroke dementia.

Characteristics of vascular lesions have been identified that are linked to the development of a clinical picture of dementia. Yet, the characteristics of the brain in which infarction or brain haemorrhage occur are equally important. Recent (clinical, epidemiological and neuropathological) studies highlight the high frequency with which neurodegenerative and vascular processes coexist in the same brain, and the fact that both processes share environmental and genetic risk factors. The diagnostic criteria currently in use consider the existence of a vascular pathology as being an exclusion criterion for the diagnosis of an Alzheimer type dementia, and thus rule out the possibility of studying the interaction between the two processes. Instead of restrictive criteria, pragmatic instruments must be used to classify the possible aetiology in these patients.

It is important to study the coexistence of vascular and degenerative pathologies in the brains of patients with a post stroke deterioration. Proving the existence of a synergic relation between the two processes would open up the possibility of performing an operation to prevent and treat the dementia displayed by these patients.