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The Vascular Brain Injury Scoring Sheet
Author(s) -
Zarow Chris,
Vinters Harry V,
Ellis William G,
Chui Helena C
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a74-a
Subject(s) - white matter , medicine , multiple sclerosis , hyperintensity , pathology , magnetic resonance imaging , radiology , psychiatry
Neuropathologists have benefited from the development of semi‐quantitative scoring instruments for Lewy body disease and Alzheimer disease, but lesion heterogeneity has posed a challenge for grading vascular brain injury (VBI). Here we introduce a standardized tissue blocking protocol and a one‐page screening instrument for evaluating the type, number, volume and location of vascular lesions in the brain. The VBI scoring sheet includes measures for hippocampal sclerosis, numbers and location of cystic infarcts, lacunar infarcts, microinfarcts in gray and white matter regions and white matter demyelination. Cystic, lacunar and microinfarcts are each defined and are scored using a semi‐quantitative rating scale. The lesions are defined anatomically by several schema: subcortical vs. cortical brain regions, paralimbic/unimodal/multi‐modal cortex, and key vs. non key regions for cognition. The correlation coefficient for the total VBI score between two board certified neuropathologists was 0.88. In order to avoid differential weighting, normalized subscores can be created based on infarct size or location. Normalized scores have been used in statistical analyses to determine the relationship between VBI and cognitive status (Chui et al, Ann Neurol 2006, in press) and between VBI and MRI volumetric measures of cortical gray matter, hippocampus, white matter hyperintensities and lacunes.