Neuroradiological findings in vascular dementia.
BACKGROUND
There are multiple diagnostic criteria for vascular dementia (VaD) that may define different populations. Utilizing the criteria of the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) has provided improved consistency in the diagnosis of VaD. The criteria include a table listing brain imaging lesions associated with VaD.


METHODS
The different neuroradiological aspects of the criteria are reviewed based on the imaging data from an ongoing large-scale clinical trial testing a new treatment for VaD. The NINDS-AIREN criteria were applied by a centralized imaging rater to determine eligibility for enrollment in 1,202 patients using brain CT or MRI.


RESULTS
Based on the above data set, the neuroradiological features that are associated with VaD and that can result from cerebral small-vessel disease with extensive leukoencephalopathy or lacunae (basal ganglia or frontal white matter), or may be the consequence of single strategically located infarcts or multiple infarcts in large-vessel territories, are illustrated. These features may also be the consequence of global cerebral hypoperfusion, intracerebral hemorrhage, or other mechanisms such as genetically determined arteriopathies.


CONCLUSIONS
Neuroimaging confirmation of cerebrovascular disease in VaD provides information about the topography and severity of vascular lesions. Neuroimaging may also assist with the differential diagnosis of dementia associated with normal pressure hydrocephalus, chronic subdural hematoma, arteriovenous malformation or tumoral diseases.
Guermazi
Ali
A
Department of Radiology Services, Synarc Inc., 575 Market Street, San Francisco, CA 94105, USA. ali.guermazi@synarc.com
Miaux
Yves
Y
Rovira-Cañellas
Alex
A
Suhy
Joyce
J
Pauls
Jon
J
Lopez
Ria
R
Posner
Holly
H
D020520:Brain Infarction / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D015140:Dementia, Vascular / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009485:Neuroradiography; D014057:Tomography, X-Ray Computed