Clinical and pathological overview of vascular dementia

Hidekazu Tomimoto^1,2

Department of Neurology¹ and Department of Dementia Prevention and Therapeutic²

　　Vascular dementia is a heterogeneous syndrome consisted mainly of multi-infarct dementia (MID), small vessel disease with dementia and strategic single-infarct dementia.　Small vessel disease with dementia is featured by lacunar infarcts and white matter lesions, and its subcortical form is designated as subcortical vascular dementia (SVD).
　　Pathologic substrates for vascular dementia are heterogeneous and range from large cystic infarction, lacunar infarction, microinfarcts, white matter lesions, to the lesions caused by cerebral hypoperfusion such as hippocampal sclerosis, laminar necrosis and borderzone infarction. Hemorrhagic lesions are also included for these substrates including cerebral hemorrhage, subarachnoid hemorrhage and cerebral microbleeds.　This review discusses the significance of each of these lesions in cognitive decline.

Address correspondence to Dr. Hidekazu Tomimoto, Department of Neurology¹ and Department of Dementia Prevention and Therapeutics², Mie University Graduate School of Medicine(Edobashi 2-174, Tsu 517-8507, Japan)