Table 1: Subtypes of vascular dementia according to major morphological lesions.


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.
Subcortical (leuko-) encephalopathy Binswanger.
Diffuse white matter lesions (myelin/axon loss), lacunes enlarged perivascular spaces, residues of microinfarcts or microbleeds.

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.
Granular cortical atrophy (multifocal cortical microinfarcts or scars-rare).

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.