1 下列何種類型失智症病因造成的認知缺損不是呈現漸進式下降(progressive progression)?
(A)腦血管中風(cerebrovascular accident)
(B)賓斯旺格病(Binswanger’s disease)
(C)庫-賈氏病(Creutzfeldt-Jakob disease)
(D)額顳葉退化(frontotemporal lobar degeneration)
統計: A(480), B(14), C(53), D(36), E(0) #2190988
詳解 (共 3 筆)
ACD的答案可以參考DSM-5,補充B選項Binswanger's disease的病程。
參考書目:
Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012).
Neuropsychological assessment (5th ed.). Oxford University Press.
Ch7. Neuropathology for Neuropsychologists--VASCULARDISORDERS--
Vascular Dementia (VaD)
內文:
Hypoperfusion and otherdisturbances of cerebral blood flow produce these
chronicischemia conditions which can result in demyelination, axonal loss,
andlacunar infarcts in the periventricular/deep and subcortical white matter
(Filley, 1995,2001; Jellinger, 2008). White matter hyperintensities show up
on MRI scans. Periventricular white matterlesions, sometimes called leukoaraioses,
can be quiteextensive and may affectas manyas 52% of multi-infarct patients,
61% of patients withAlzheimer disease, and more than a third of cognitively
healthyindividuals over age 50 (Kobari etal., 1990).
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總結:
Binswanger's disease也是血管型失智的一種,它需要由CT或MRI提供明確的造影證據做診斷
可參考這邊 http://www2.cmu.edu.tw/~cmcmd/ctanatomy/clinical/SAE.html
簡單來說它這個疾病出現認知功能的下降主要跟慢性的腦血管病變有關, 它不像中風或是動脈瘤剝落那種急性的心血管事件,可以明確判定事件之後認知障礙的進程和預後,
通常它的病程是隱伏且漸進的,透過上述的病理機制一點一滴侵蝕大腦功能。 -------------------------
♚Lezak讀本各章節重點整理
https://pse.is/3lumfu
(A) 腦血管中風(cerebrovascular accident):病程會隨著每次大小中風,而「階梯式」下降惡化