Classification and clinical criteria Classification

Vascular dementia has been divided into subtypes on the basis of clinical, radiological, and neuropathological features. It is uncertain whether these subtypes are distinct disorders, with separate pathological and clinical features, and responses to therapy. (27> If homogenous subtypes could be identified the comparability of research studies would be greater and multicentre studies easier.(28)

The subtypes of vascular dementia included in most classifications include multi-infarct dementia (cortical lesions), small-vessel dementia (subcortical deep lesions), and strategic infarct dementia.(1. 1¿l2.9,3 and 3!) Many include also hypoperfusion dementia.(l ,!43°,33) Further suggested subtypes include haemorrhagic dementia, hereditary vascular dementia, and combined or mixed dementia (Alzheimer's disease with cerebrovascular disease).

DSM-IV(34) does not specify subtypes. ICD-10(35> includes six subtypes (acute onset, multi-infarct, subcortical, mixed cortical and subcortical, other, and unspecified). The NINDS-AIREN criteria(30) include, without detailed description, cortical vascular dementia, subcortical vascular dementia, Binswanger's disease, and thalamic dementia.

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