Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan.
Neurosci Res. 2011 Nov;71(3):193-9. doi: 10.1016/j.neures.2011.07.1820. Epub 2011 Jul 27.
Subcortical vascular dementia (SVD) is a small vessel disease with dementia that exhibits relatively uniform clinical and pathological features and constitutes approximately half of vascular dementia (VaD) cases. This subtype is further classified into Binswanger's disease and multiple lacunar infarctions. The former is characterized by diffuse white matter lesions, and the latter is characterized by lacunar infarctions. Both of these entities are related to hypertensive small vessel changes. Subcortical vascular dementia may exhibit slowly progressive vascular Parkinsonism and dementia but can be differentiated from Alzheimer's disease because it is associated with more extensive white matter lesions, less severe hippocampal atrophy and the absence of cerebral amyloid angiopathy (CAA), which may be indicated radiologically by lobar microbleeds, cortical subarachnoid hemorrhage (SAH) and cortical microinfarctions. Cerebral amyloid angiopathy may manifest as dementia and constitute the cortical type counterpart of SVD in small vessel disease with dementia. This paper provides an overview of the clinical features, pathogenesis and treatment for SVD, as well as its relationship to CAA and Alzheimer's disease.
皮质下血管性痴呆（SVD）是一种以痴呆为表现的小血管疾病，具有相对均匀的临床和病理特征，约占血管性痴呆（VaD）病例的一半。这种亚型进一步分为 Binswanger 病和多发性腔隙性梗死。前者的特征是弥漫性白质病变，后者的特征是腔隙性梗死。这两种情况都与高血压小血管变化有关。皮质下血管性痴呆可能表现为进行性血管帕金森病和痴呆，但可以与阿尔茨海默病区分开来，因为它与更广泛的白质病变、较轻的海马萎缩和无脑淀粉样血管病（CAA）有关，后者可能通过脑叶微出血、皮质下蛛网膜下腔出血（SAH）和皮质微梗死在影像学上表现出来。脑淀粉样血管病可能表现为痴呆，并构成小血管疾病伴痴呆的皮质型 SVD 的对应物。本文概述了 SVD 的临床特征、发病机制和治疗方法，以及它与 CAA 和阿尔茨海默病的关系。
