Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • history of stroke(s)
  • focal neurological signs
  • impaired gait and balance
  • difficulty solving problems
  • apathy
  • disinhibition
  • slowed processing of information
  • poor attention
  • retrieval memory deficit
  • frontal release reflexes

Risk factors

  • age >60 years
  • obesity
  • hypertension
  • cigarette smoking
  • diabetes mellitus
  • hypercholesterolaemia
  • alcohol abuse

Diagnostic investigations

1st investigations to order

  • FBC
  • erythrocyte sedimentation rate
  • blood glucose level
  • renal and LFTs
  • syphilis serology
  • vitamin B12
  • folate
  • thyroid function
  • CT or MRI brain
  • ECG
Full details

Investigations to consider

  • lupus anticoagulant, antiphospholipid, and antinuclear testing
  • neuropsychological testing
  • carotid duplex
  • echocardiogram
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Ageing and Geriatric Medicine

Queen's University Belfast

Belfast

UK

Disclosures

PP declares that he has no competing interests.

Dr Peter Passmore would like to gratefully acknowledge Dr David Wilson, Dr Grant Bateman, and Dr Velandai Srikanth, previous contributors to this monograph. DW has received educational grants from Shire. GB and VS declare that they have no competing interests.

Peer reviewers VIEW ALL

Medical Director

Kings Harbor Multicare Center

New York

NY

Disclosures

RJG declares that he has no competing interests.

Affiliate Assistant Professor

Department of Psychiatry and Behavioral Sciences

University of Washington Medical Center

Seattle

WA

Disclosures

CNS declares that he has no competing interests.

Assistant Professor and Clinical Neuropsychologist

Department of Neurological Sciences

Rush University Medical Center

Chicago

IL

Disclosures

BB declares that he has no competing interests.

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