Cerebrovascular Disease in Italy and Europe: It is Necessary to Prevent a 'Pandemia'

Abstract

In Italy and Europe, strokes are the third most common cause of death and resulting invalidity. In the ever-increasing 80-years-old-and-over people, strokes become more serious due to the clinical presentation during the acute phase and the ten-times higher mortality, but also in relation to the twice as high resulting disability as for younger subjects. However, stroke prevention is possible both through correct behavioural habits and pharmacological means. Besides the wellknown preventive effects of an adequate anti-hypertensive, anti-diabetic and/or anti-aggregant/anti-coagulant therapy, there are increasing evidences of the effectiveness of the anti-hypercholesterolemic therapy in stroke prevention. Moreover, a great part of the risk factors for the cerebrovascular disease coincides with those for cardiovascular disease, for which the correction of the former automatically involves a reduction in incidence of both pathologies. In this context, a statin's rational use can therefore represent an important tool for the combined prevention of the two pathologies. Finally, different hypotheses link the origin of Alzheimer's disease to that of progressive cerebrovascular dementia caused by cerebral microcirculation damage. It is plausible that the application of a suitable early prevention of the cerebrovascular pathology could bring to a more late slatentisation and less serious demonstrations of Alzheimer's disease, when this is destined to develop.

Neuropsychiatry of Complex Visual Hallucinations

“…Correction of predisposing factors via interventions such as cataract surgery [61], laser photocoagulation of the retina [67] and the use of optical correcting devices [68] can be important additional considerations. Additionally, there is increasing evidence that controlling risk factors for cerebrovascular disease in elderly populations is important in preventing stroke and maintaining functional level [69, 70]. Visual hallucinations may therefore herald underlying cerebrovascular disease, and investigation and addressing risk factors such as hyperlipidaemia, hypertension and diabetes control may be equally important therapeutic aims.…”