Add or change institution. Save Preferences. Privacy Policy Terms of Use. Access your subscriptions. Free access to newly published articles. Purchase access. Rent article Rent this article from DeepDyve. Access to free article PDF downloads. Save your search. Customize your interests. Depending on which part of the brain is suspected as the primary location of the dementia, the type of dementia may be classified as either cortical or subcortical.
While some physicians don't use these classifications of cortical or subcortical often, others find some value in categorizing the types of dementia into these groups based on the initial primary location of damage in the brain. Whichever area of the brain cortical or subcortical that is affected will typically demonstrate more physical changes initially, such as atrophy shrinkage. Often, the classification of dementia as cortical or subcortical is less helpful than actually determining the specific type of dementia present.
This is because each type of dementia has its own expected set of characteristics, symptoms, and prognosis. The cortex of the brain the word cortical refers to the cortex is the part most people are familiar with, at least when it comes to appearance. The characteristic twists and turns of the outer layers play an important role in processing information and in functions such as language and memory. Cortical dementia is typically associated with the brain's gray matter.
As the term suggests, these are dementias believed to initially affect structures below the cortex sub means below and are more associated with the brain's white matter. Huntington's disease , Parkinson's dementia , and AIDS dementia complex are three examples of conditions classified as subcortical dementia.
It is more common to see changes in personality and a slowing down of thought processes in subcortical dementias. Language and memory functions often appear largely unaffected in the earlier stages of these dementias. Treatments and management of dementia generally have focused most on Alzheimer's disease since it's the most common cause of dementia.
These medications are sometimes used to treat other kinds of dementia as well, although they are FDA-approved specifically for Alzheimer's. Non-drug approaches can also be helpful in treating dementia. Physical exercise , diet , and mental activity have all demonstrated benefits in research for those living with a variety of dementias, whether cortical or subcortical.
The prognosis of cortical and subcortical dementias varies significantly. Several different types of dementia fall into these categories, and progression is affected by a multitude of factors. Similar deficits can occur with cortical strokes affecting the temporal and parietal lobes where the optic radiations travel. Other more complex, cortical visual abnormalities may be seen with occipital lobe strokes such as palinopsia, which is a persistence of visual perception of an object after an object is removed.
It is rare for a subcortical stroke to impair vision. Cortical stroke may present with a gaze preference. This occurs when the frontal eye fields, responsible for horizontal gaze, are infarcted. This results from the unopposed action of the left frontal eye fields on horizontal gaze to the contralateral right side. Lesions which are subcortical in the brainstem may present with signs and symptoms such as extraocular movement impairments, diplopia, dysphagia, dysarthria, nystagmus.
A subcortical stroke in the cerebellum may present with nausea, vomiting, vertigo, imbalance. Exam may reveal nystagmus, ataxia and tremor. Exceptions may occur. Clinical Differentiation: Cortical vs. Subcortical Strokes Cortical Subcortical A stroke may affect cortical regions of the cerebral cortex, including the frontal, parietal, temporal and occipital lobes, or structures subcortically, below the cortex, including the internal capsule, thalamus, basal ganglia, brainstem and cerebellum.
Neuroscience Clerkship Home Learning Objectives. A stroke may affect cortical regions of the cerebral cortex, including the frontal, parietal, temporal and occipital lobes, or structures subcortically, below the cortex, including the internal capsule, thalamus, basal ganglia, brainstem and cerebellum.
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