Crunching the total cerebral small vessel disease score can evaluate brain health writ large. Cobbling individual neuro markers into a one, singular composite serves as a critical prognostic indicator for both dementia and recurrent stroke. And as Dr. Abdel Mahammedi noted during this ARRS Quick Byte video, total SVD ranges from 0 to 4, allocating one point for each of the following four markers:
- Lacunes: Presence of any subcortical lacunar cavities
- Microbleeds: Detection of one or more microbleeds on T2*-weighted or susceptibility-weighted MRI.
- EPVS: Observing >20 enlarged perivascular spaces in basal ganglia.
- WMH: Moderate-to-severe Fazekas score of 2 or 3.
Case in Point: Dr. Mahammedi’s high-risk patient exhibited each and every marker; two months later, that patient suffered an acute lacunar infarct, highlighting PPV of high SVD burden.
RadFYI: Adopting total SVD score in routine practice helps standardize the gauge of cumulative vascular injury, stratifying cerebrovascular and cognitive risks alike.
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