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From the Section of Cerebrovascular Disease, Department of Neurological Sciences (Dr. Gorelick, T.J. Dollear, and Y. Harris), Rush Medical College of Rush University, Chicago, and the Epidemiology and Biometry Program, School of Public Health (Drs. Gorelick and Freels, and T.J. Dollear), University of Illinois at Chicago, IL; and the Department of Radiology (Dr. Charletta), Baylor College of Medicine, Houston, TX.
Supported in part by NIA grant no. RO1-AG10102-03 (P.B.G.), the M.R. Bauer Foundation, and the Marjorie and Herbert Fried Scholarship Fund.
Received August 17, 1994. Accepted in final form January 4, 1995.
Address correspondence and reprint requests to Dr. Philip B. Gorelick, 1725 W. Harrison, Suite 755, Chicago, IL 60612.
We compared CT and MRI findings among 78 Alzheimer's disease (AD), 66 vascular dementia (VaD), and 41 stroke without dementia (SWD) African-American patients to identify possible neuroimaging indicators of dementia. The patients with AD and VaD were generally older and less educated than those with SWD. VaD and SWD patients had a higher frequency of cardiovascular disease risk factors than those with AD. In multivariate analysis, the CT data showed that the presence of white matter lesions, nonlacunar infarcts, and left subcortical infarcts were predictors of VaD when compared with AD, whereas atrophy of the third ventricle and equal distribution of white matter lesions distinguished VaD from SWD. On MRI, atrophy of the temporal sulci, temporal horns, and the third ventricle, and right hemisphere infarcts, distinguished AD from VaD, while atrophy of the third ventricle differentiated VaD from SWD. These data suggest that atrophy, especially at the level of the third ventricle, presence of infarcts, and white matter lesions may be useful predictors of dementia subtype. Furthermore, the qualitative CT and MRI findings among our African-American patients were similar to those reported in other dementia studies.
NEUROLOGY 1995;45: 1456-1461
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