Vascular dementia - A cerebrovascular disease Factor
RMA definition
‘Cerebrovascular disease’ means any abnormality of the brain resulting from a pathologic process of the cerebral blood vessels or decreased blood flow to the brain, including cerebral ischaemia, intracerebral haemorrhage or cerebral infarction’.
Note:
This definition includes cerebrovascular accident (CVA, stroke). However, for CCPS purposes, only non-CVA cerebrovascular disease should be dealt with under this contention.
General information
Cerebrovascular disease is common with aging and is frequently silent.
A diagnosis of cerebrovascular disease would be confirmed via radiological investigations such as computed tomography (CT) scans or magnetic resonance imagery (MRI). Cerebrovascular disease may be a consequence of a state of chronic hypoperfusion arising from outside the brain such as may occur with chronic cardiac failure or cardiac surgery where there is a clearly associated cognitive decline.
The most common form of cerebrovascular disease is chronic and progressive atherosclerotic change to the cerebral vessels. 437.0 (cerebral atherosclerosis) would be an appropriate ICD 9 code to use for this.
Less common forms of cerebrovascular disease also include more obscure vascular pathologies associated with deep white-matter lesions (as seen in Binswanger’s disease), small-vessel disease, arteriovenous malformations, lacunar and cortical infarcts or lesions. Cerebrovascular disease may be inflammatory (vasculitis) or non-inflammatory (arteriopathy) and includes the following rare conditions:
- Behcet's disease
- Cerebral amyloid angiopathy
- Fabry's disease
- Fibromuscular dysplasia
- Giant-cell arteritis
- Moyamoya disease
- Polyarteritis nodosa (PAN)
- Serum sickness
- Sjogren's syndrome
- Spatz-Lindenberg disease
- Systemic lupus erythematosus
- Takayasu's disease
LAST REVIEWED FOR CCPS 08 JANUARY 2007
PRELIMINARY QUESTIONS [36162]
36173 there is some evidence that a cerebrovascular disease may be a factor in the development or worsening of the condition under consideration.
23994 the veteran has suffered from a cerebrovascular disease affecting the cerebral vessels at some time.
36174 a cerebrovascular disease means any abnormality of the brain resulting from a pathologic process of the cerebral blood vessels or decreased blood flow to the brain, including cerebral ischaemia, intracerebral haemorrhage or cerebral infarction.
36175 the veteran has established the causal connection between the cerebrovascular disease and VEA service for vascular dementia.
36182 the veteran had the identified illness or injury, a cerebrovascular disease, before the clinical onset of vascular dementia.
36176 the veteran has established the causal connection between the cerebrovascular disease and VEA service for the clinical onset of vascular dementia.
36178 the veteran has established the causal connection between the cerebrovascular disease and operational service for the clinical onset of vascular dementia.
or
36179 the veteran has established the causal connection between the cerebrovascular disease and eligible service for the clinical onset of vascular dementia.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
36183 the veteran had the identified illness or injury, a cerebrovascular disease, before the clinical worsening of vascular dementia.
36177 the veteran has established the causal connection between the cerebrovascular disease and VEA service for the clinical worsening of vascular dementia.
36180 the veteran has established the causal connection between the cerebrovascular disease and operational service for the clinical worsening of vascular dementia.
or
36181 the veteran has established the causal connection between the cerebrovascular disease and eligible service for the clinical worsening of vascular dementia.
CLINICAL ONSET AND OPERATIONAL SERVICE [36178]
36184 the identified illness or injury, a cerebrovascular disease, is causally related to operational service.
CLINICAL ONSET AND ELIGIBLE SERVICE [36179]
36185 the identified illness or injury, a cerebrovascular disease, is causally related to eligible service.
CLINICAL WORSENING AND OPERATIONAL SERVICE [36180]
36184 the identified illness or injury, a cerebrovascular disease, is causally related to operational service.
36186 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a cerebrovascular disease, is causally related.
CLINICAL WORSENING AND ELIGIBLE SERVICE [36181]
36185 the identified illness or injury, a cerebrovascular disease, is causally related to eligible service.
36187 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a cerebrovascular disease, is causally related.