Subcortical vascular cognitive impairment

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By John V Bowler MD and Vladimir C Hachinski MD

Subcortical vascular cognitive impairment is also known as or subsumes Subcortical vascular dementia. -ed.

Subcortical vascular cognitive impairment, characterized by subcortical and executive cognitive dysfunction, is now recognized to be the most common form of vascular cognitive impairment. It arises on the basis of small vessel cerebrovascular disease, in turn, causing lacunar infarcts and ischemic damage to the deep white matter. Most importantly, the underlying etiologies are those of well-recognized vascular risk factors, and this is, therefore, a form of cognitive impairment that is amenable to prevention as well as symptomatic relief.

Key points

  • Subcortical vascular cognitive impairment is the commonest form of vascular cognitive impairment.
  • The most severe cognitive deficits are frontal and executive.
  • Seventy percent of the risk is inherited.
  • Progression is slow early on but becomes more rapid, with increasing severity.
  • There is an association between subcortical vascular cognitive impairment, microhemorrhage, and intracerebral hemorrhage.