Table 2.

Pantoni etiologic classification of cerebral small vessel disease.

(adapted from [34])

Type	Designation	Key vessel pathology	Representative causes	Relevance to cognition
1	Arteriolosclerosis	Hyaline wall thickening, fibrinoid necrosis, lipohyalinosis	Aging, hypertension, diabetes	Most common form; driver of WMH, lacunes, subcortical dysexecutive syndrome
2	Cerebral amyloid angiopathy	Amyloid-beta in media/adventitia of cortical/leptomeningeal vessels	Aging, APOE	Lobar microbleeds, siderosis, lobar hemorrhage; vascular-neurodegenerative interface
3	Inherited/genetic SVD distinct from CAA	Genetically determined arteriopathy	CADASIL, CARASIL, COL4A1/A2, Fabry, MELAS	Pure SVD models without cardiac risk factors
4	Inflammatory/immune-mediated	Vessel-wall inflammation	Primary CNS angiitis, systemic vasculitides, infection	Part of systemic disease; potentially reversible
5	Venous collagenosis	Noninflammatory collagenous venular thickening	Advanced age	Implicated in periventricular white matter change
6	Other	Miscellaneous	Postradiation angiopathy; nonamyloid microvessel degeneration	Includes microvascular degeneration in AD