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Journal of Neurosonology 2017;9(1):7-11.
Published online November 30, 2017.
Subcortical New Diffusion Restricted Lesions are Associated with Acute Manifestation of Vascular Cognitive Impairment
Do Yeon Kim, MD1, Seonkyung Lee, MD2, Ahwon Kim, MD2, Hyung-Min Kwon, MD, PhD2
1Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
2Department of Neurology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
새롭게 나타난 피질하 확산 제한 병변과 혈관성 인지장애의 급성 징후와의 연관성
김도연1, 이선경2, 김아원2, 권형민2
1서울대학교 의과대학 서울대학교병원 신경과
2서울대학교 의과대학 서울특별시보라매병원 신경과
Correspondence:  Hyung-Min Kwon, MD, PhD, Tel: +82-2-870-2475, Fax: +82-2-831-2826, 
Email: hmkwon@snu.ac.kr
Received: 2 June 2017   • Accepted: 30 August 2017
Abstract
Background
Vascular dementia is progressed as a “stair-step” course and this feature becomes important point of difference compared to Alzheimer’s dementia. Aggravation of vascular dementia caused by symptomatic stroke could be diagnosed easily with diffusion-weighted imaging (DWI) sequence of magnetic resonance imaging (MRI) scan, however, cognitive decline in dementic patients is not clearly associated with the extent of white matter hyperintensity (WMH).
Methods
We collected patients who presented acute cognitive impairment with objective diffusion-restricted lesions in DWI sequences from November 2016. Korean mini-mental status examination (K-MMSE) were done in all patients.
Results
There are three depicted cases which showed the onset of vascular cognitive impairment as a progression of WMH, but not explained as a symptomatic ischemic stroke.

Conclusion
s

Onset of non-stroke, subcortical and periventricular vascular cognitive impairment was observed with DWI and T2 FLAIR MRI scan. If patients are presented with initial and acute-onset cognitive impairment, new subcortical and periventricular white matter disease could be one of differential diagnosis, as well as cortical infarction or strategic infarction.
Key Words: Vascular dementia, Cognition, Diffusion magnetic resonance imaging, White matter
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