Relationship between periventricular lucencies on computed tomographic scans and vascular dementia

We evaluated 48 consecutive patients with periventricular lucencies (PVL) on CT scan of brain to determine the clinical significance of this finding. Twenty-one (43.7%) patients were demented; 27 (56.3%) patients had no dementia but had various other diseases. PVL were frequently associated with hypertension and previous stroke. We used a PVL scoring system to evaluate the degree of PVL. When the score was greater than 3.5, the sensitivity and specificity in separating vascular dementia from other diseases with PVL were 78% and 67% respectively (Kappa = 0.42). We conclude that although mild PVL may be a frequent but non-specific finding in patients with hypertension or previous stroke, moderate and severe PVL should raise the possibility of vascular dementia.