Main subtypes

Multi-infarct dementia or cortical vascular dementia, and small-vessel dementia or subcortical vascular dementia are the two common subtypes, although their frequencies vary in different series.(!. I4,31,)

Cortical vascular dementia relates to large-vessel disease, cardiac embolic events, and hypoperfusion. Infarcts are predominantly in the cortical and corticosubcortical arterial territories, and their distal fields (watershed). Typical clinical features are lateralized sensimotor changes and the abrupt onset of cognitive impairment and aphasia.(3!> A combination of different cortical neuropsychological syndromes has been suggested to occur in cortical vascular dementia. (36)

Subcortical vascular dementia, or small-vessel dementia, incorporates the entities 'lacunar state' and 'Binswanger's disease'. It relates to small-vessel disease and hypoperfusion, with predominately lacunar infarcts, focal and diffuse ischaemic white-matter lesions, and incomplete ischaemic injury. (3,36,37) Clinically, small-vessel dementia is characterized by pure motor hemiparesis, bulbar signs, dysarthria, depression, and emotional lability, and especially deficits in executive functioning/3,3,38 and 39>

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