Pathology and pathophysiology of cerebrovascular dementia: pure subgroups of obstructive and hypoperfusive etiology.

The brains of 175 consecutive autopsy cases of dementia, clinically studied prospectively, were analyzed pathoanatomically with regard to type, size and site of lesions. Pure groups of vascular dementia caused by large or small vessel disease and by hypoperfusion could be defined. The infarcts were either complete with a more or less pronounced incomplete perifocal component or of an incomplete type only. Incomplete infarction appears to be an important and yet little appreciated cause of brain dysfunction. These groups could be used as a basis for a pathoanatomical classification of vascular dementias. Vascular dementia is much more common than generally assumed.