[Multi-infarct and Alzheimer dementia--problems of differential diagnosis]

The differential diagnosis of Alzheimer's and so-called multi-infarct dementia is still a major problem in clinical dementia research. It was Binswanger who in 1894 pointed out that a subtype of vascular dementia exists which is characterized by subcortical arteriosclerotic encephalopathy. It is this type that can most easily be mistaken for Alzheimer's dementia, presented for the first time in 1906, which may be associated with congophilic angiopathy leading to brain infarction. Beyond clinical criteria, which in part are summarized in Hachinski's ischemic score, further advancement of brain imaging techniques, especially those yielding perfusion or metabolic data, has facilitated and substantiated clinical in vivo distinction.