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. 2013 Apr 10;5:17. doi: 10.3389/fnagi.2013.00017

Table 7.

Classification of VaD according to major morphologic lesions (modified from Jellinger, 2007a).

A. MULTIFOCAL/DIFFUSE DISEASE
  1. Large vessel dementia (LVD)
    • Multiple infarct dementia (MID): Multiple large artery/borderline infarcts, cortical and subcortical, with perifocal lesions in gray and white matter.
  2. Small vessel dementia (SVD)
    • Subcortical infarct dementia:
      • Multiple small lacunar infarcts with perifocal lesions in white matter.
      • “Granular atrophy” of cortex (multifocal cortical microinfarcts)
      • Lacunes and multilacunar state
      • Binswanger subcortical (leuko)encephalopathy
      • Hereditary angiopathies—CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) and others
    • Cortical plus subcortical infarct dementia:
      Multiple, restricted small infarcts due to:
      • Hypertensive and arteriolosclerotic angiopathy
      • Cerebral amyloid angiopathy, with/without hemorrhages
      • Collagen or inflammatory vascular disease (angiitis, PCNSA, FMD)
      • Hereditary forms of CAA

  3. Hypoperfusive, hypoxic-ischemic dementia (HHD)

    • Incomplete white matter infarcts

    • Anti-PL related ischemia

    Diffuse hypoxic-ischemic encephalopathy (cortical lacunar necrosis, post cardiac arrest, hypotension)

  4. Venous infarct dementia
    • Large hemorrhagic, congestive symmetric infarcts due to thrombosis of the sagittal sinus or the great vein of Galen
  5. Hemorrhagic dementia
    • Subdural hemorrhage
    • Subarachnoid hemorrhage
    • Intracerebral hemorrhage
    • Multiple microbleeds, particularly subcortical
B. FOCAL DISEASE/STRATEGIC INFARCT DEMENTIA (SID)
  • Small infarcts restricted to functional important regions
    • Mesial temporal (including hippocampal) infarcts/ischemia/sclerosis
    • Caudate and thalamic infarcts (especially DM nucleus, bilateral lesions)
    • Fronto-cingulate infarcts (basal forebrain, ACA)
    • Angular gyrus infarct (dominant cerebral hemisphere - ACA and MCA territories)
    • White matter key areas

Anti-PL, anti-phospholipid; PCNSA, primary angiitis/arteritis of the central nervous system; FMD, fibromuscular dysplasia; ACA, anterior cerebral artery; DM, dorsomedial; CAA, cerebral amyloid angiopathy.