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Stroke and Alzheimer's Disease
  1. PETER MARTIN

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    Stroke and Alzheimer's Disease. Edited by didier leys, florence pasquier, and philip scheltens. (Current Issues in Neurodegenerative Diseases Volume 9). (Pp 225). Published by Holland Academic Graphics, The Hague, 1998. ISBN 90-5560-061-9.

    Volume nine of the Current Issues in Neurodegenerative Diseases series examines the interplay between cerebrovascular disease and dementia, particularly Alzheimer's disease. Two hundred pages of what are essentially 20 brief review articles comprise this text, sadly without any illustrations. Ploughing through the introduction to each chapter there is a certain sense of deja vu, although on the positive side each contribution is extremely well referenced.

    The book is divided into five sections covering the historical concepts of vascular and Alzheimer's dementias, the arguments for a pure vascular dementia, the role of Alzheimer's disease in the genesis of dementia after stroke, the contribution of white matter changes on neuroimaging to dementia, and finally a short section examining practical questions such as the management of stroke in patients with dementia.

    Although common conditions in their own right, stroke and Alzheimer's disease do seem to cross paths more often than would be expected by chance alone, and more often than can be explained by the presence of amyloid angiopathy and recurrent lobar haemorrhages. Perhaps common genetic factors are responsible and here the APoE alleles are discussed. The comprehensive section on deep white matter lesions seeks to explain the connection further—and convinces the reader that there is still a lot which is not well understood. It is in this section particularly that illustrations are greatly missed. Brief mention is made of other conditions which may produce white matter changes and dementia such as CADASIL, cerebral lupus, and the primary antiphospholipid syndrome.

    Some typographical errors and mistranslations detract a little further from a book which seems unlikely to appeal to most neurologists, although it will no doubt be a source of reference to those working in the field of cognitive disorders, particularly vascular dementias.

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