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. Author manuscript; available in PMC: 2009 Feb 25.
Published in final edited form as: Semin Neurol. 2008 Oct 8;28(4):467–483. doi: 10.1055/s-0028-1083695

Figure 4.

Figure 4

Axial T2 images in four patients with different types of VaD. (A) An 84-year-old woman with cognitive deficits (MMSE 26, which 2 years later declined to 15). T2-weighted MRI shows chronic right temporal pole infarction and only mild left hippocampal atrophy. (B) A 79-year-old man with behavioral, frontal-executive, and memory problems (MMSE 19). T2-weighted MRI shows chronic left thalamic lacunar stroke, bilateral caudate and frontal white matter small vessel disease, as well as bifrontal atrophy. (C) A 72-year-old woman with memory impairment (MMSE 24) diagnosed with mixed AD-VaD. T2-weighted MRI shows bilateral hippocampal atrophy and multiple microhemorrhages (focal hypointensities, arrows) suggestive of amyloid angiopathy. (D–F) A 49-year-old man with CADASIL and progressive behavioral and memory disturbances (MMSE 27). Axial T2-weighted MRI shows diffuse bilateral leukoencephalopathy involving (D) the centrum semiovale, (D,E) anterior and posterior deep white matter, (E) internal and external capsules (arrow), (F) subcortical white matter of temporal poles (arrows), and the pons, and (E) a lacunar stroke in the right thalamus and microhemorrhages primarily in the left thalamus. This MRI pattern, with the bilateral anterior temporal lobe white matter hyperintensity, is highly suggestive of CADASIL. VaD, vascular dementia; MMSE, Mini Mental Status Exam; MRI, magnetic resonance imaging; AD, Alzheimer’s disease; CADASIL, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.