The International Neuropsychiatric Congress provided a critical forum for exchanging information about these disorders, sharing experience with treatment of these syndromes and coordinating plans for disseminating information in neuropsychiatry. Rapid dispersal of new information relevant to neuropsychiatric care is an important agenda for the world neuropsychiatric community. A second international neuropsychiatric congress is under active consideration. Creation of an international neuropsychiatric home page on the World Wide Web is planned, and an increase in international activity by the American Neuropsychiatric Association is also being contemplated. Vascular Dementia Philip Gorelick, M.D., of Rush-Presbyterian St. Luke's Medical Center, Chicago, presented an update on vascular dementia.
Most vascular dementia is related to stroke.
Patients sustaining a stroke have a five-fold increased risk of developing dementia within the next five years compared to control patients without strokes. They also have a three-fold increased risk of death within the next five years. Risk factors for vascular dementia that have been proven or for which substantial evidence exists include age, a past myocardial infarction, current smoking, low educational level, diabetes, a previous stroke, a left-brain infarction and an elevated systolic blood pressure. Neuroimaging features on computed tomography or magnetic resonance imaging that favor the diagnosis of vascular dementia in a patient with cognitive impairment include white matter lesions, a widened third ventricle and a stroke involving subcortical structures of the left hemisphere. In contrast, marked temporal lobe atrophy favors a diagnosis of Alzheimer's disease more than vascular dementia.