Dergi Ara >>
Yıl:2003; Cilt: 3; Sayı: 1>> Özet
Demans Dergisi; 2003;3(1):15-20
Post Strok Demans (Epidemiyoloji ve Risk Faktörleri)
M Bakar
Uludağ Üniversitesi Tıp Fakültesi Nöroloji ABD, Bursa
Demans, vasküler risk faktörleri olan olgularda
daha ciddi seyreder. Vasküler faktörlerin tanınması
demansın önlenmesi için daha iyi fırsatlar verdiğinden,
çalışmalar daha çok bu konuya yönlendirilmiştir.
Vasküler risk faktörleri demansın
diğer tiplerinin seyrinde ve gelişmesinde de önemli
bir rol oynayabilir. Preklinik Alzheimer hastalığı
(AH) olan olgular da geçirdikleri stroktan hemen
sonra demans olabilirler.
Poststrok demans (PSD) üzerinde en çok çalışılan
bir antite olup prevalansı beklenenden çok daha
fazladır ve strokun varlığı demans sıklığını 4-12 kez
arttırır. Strok hastaları için demansa maruz
kalmanın sebepleri henüz tam olarak anlaşılamamıştır.
Demans tam olarak beyin damar
hastalığı (BDH) lezyonu ile direkt ilişkili olmayabilir
ve bazı olgularda strok sonrası gelişen demans
daha yavaş başlangıç ve progresif bir seyir gösterebilir.
Son çalışmalarda strok nedeniyle kliniğe
kabul edilen bir çok olgunun önceye ait kognitif
azalmasının olduğu saptanmıştır. Strok geçiren
olguların tümünde demans gelişmez, bu nedenle
PSD'ye yol açan risk faktörlerinin saptanması
önemlidir. Bir çok çalışma bu risk faktörlerine yönlendirilmiş
olmasına rağmen tam bir konsensus
sağlanamamıştır. Ortaya çıkan karmaşık sonuçlar
muhtemelen hasta seçimi ve demansın tanımlanmasından
kaynaklanmaktadır .

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