Table 1: Subtypes of vascular dementia according
to major morphological lesions.
Condition |
Imaging and pathological changes. |
1. Multi-infarct dementia (MIE) |
Multiple large and/or small
infarcts in the supply territories or borderlines of large cerebral arteries,
in particular ACM, ACM + ACP, uni- or bilateral. |
2. Small vessel dementia (SVD)
(subcortical VaD) |
Mutiple lacunes/microinfarcts in
cerebral white matter. |
3. Strategic infarcts dementia |
Small or medium-sized infarcts in
strategic locations (thalamus,hippocampus, basal forebrain, disruption of
subcortico-cortical circuits. |
4a. Hypoperfusion dementia |
Watershed infarcts or scars in
cortical and cortico-subcortical border zones of large cerebral arteries or
of cortical and subcortical vessels. |
4b. Hypoxic dementia |
Pseudolaminar cortical necrosis
mainly in arterial border zones (postischemic lesions). |
5. Hereditary (VaD-CADASIL):
CARASIL, etc. |
Multiple lacunes and white matter
lesions. |
6. Hemorrhagic dementia |
Multiple hemorrhages (subdural,
subarachnidal, intracerebral), multiple cortical and subcortical microbleeds
and residues. |
7. Venous infarct dementia |
Large symmetric congestive
hemorrhagic infarcts due to thrombosis of the sagittal sinus or the great
vein of Galen. |
8. Hippocampal sclerosis |
Diffuse or sector CA2 necrosis or
gliosis. |
9. Alzheimer disease with CVD
(mixed dementia) |
Combination of AD-type pathology
(plaques and tangles) and cerebrovascular changes of different types and
locations. |
ACM: Middle
cerebral artery; ACP: Posterior cerebral artery; CADASIL: Cerebral autosomal
dominant arteriopathy with subcortical infarcts and leukoencephalopathy.