NINDS-AIREN Criteria for Probable Vascular Dementia
1. Dementia, defined by
□ Cognitive decline from a previously higher level of functioning
□ Impairment of memory and of two or more cognitive domains…
□ Severe enough to interfere with activities of daily living and not due to physical effects of stroke alone.
□ Cases with disturbance of consciousness, delirium, psychosis, severe aphasia, or major sensorimotor impairment precluding neuropsychological testing.
□ Also excluded are systemic disorders or other brain diseases (such as AD) that in and of themselves could account for deficits in memory and cognition.
2. Cerebrovascular disease (CVD), defined by
□ Focal signs on neurological examination…consistent with stroke (with or without history of stroke)
□ Evidence of relevant CVD by brain imaging (CT or MRI) including multiple large-vessel infarcts or a single strategically placed infarct…, as well as multiple basal ganglia and white matter lacunes or extensive periventricular white matter lesions or combinations.
3. A relationship between the above two disorders manifested or inferred by the presence of one or more of the following:
□ Onset of dementia within three months following a recognized stroke
□ Abrupt deterioration in cognitive functions, or fluctuating, stepwise progression of cognitive deficits
□ Clinical features consistent with the diagnosis of probable vascular
□ Early presence of a gait disturbance
□ History of unsteadiness and frequent, unprovoked falls
□ Early urinary symptoms not explained by urologic disease
□ Pseudobulbar palsy
□ Personality and mood changes, abulia, depression, emotional incontinence, or other subcortical deficits…
Adapted from NINDS-AIREN work group, Roman et al. 1993
Clinical Classification of Vascular Dementia Syndromes
1. □ Multi-infarct dementia
2. □ Subcortical ischaemic dementia
□ Lacunar state
□ Diffuse leukoaraiosis ( Binswanger’s encephalopathy )
3. □ Strategic infarction
□ Medial thalamic infarcts
□ Lateral thalamic infarcts—internal capsular infarcts
□ Caudate and pallidal infarction
□ Posterior cerebral artery infarction
□ Left angular gyrus (Gerstmann’s) syndrome
□ Basal forebrain infarction