With the ageing population, number of dementia patients is on the rise, as well as the public interest. The population who would visit memory disorder clinic will also grow. The diagnostic significance of brain MRI in dementia lies in idetifying hippocampal atrophy or ischemic lesions. However, patients visiting memory disorder clinic are mostly old-aged with multiple vascular risk factors, raising the risk of cerebrovascular abnormalities. The authors set out to evaluate the need for cerebrevascular imaging in patients who visited memory disorder clinic.

The study recruited patients who visited the memory clinic in Seoul medical center between July 2011 and June 2012. Among those, patients who had taken the neuropsychiatric test and had both brain MRI and MRA taken were included for analysis. In brain MRI, severities of white matter hyperintensities and presence of cerebral infarction were assessed. In brain MRA, intra- and extra-cranial arterial stenosis and presence of aneurysm were noted.

A total of 173 patients was included, and 64 were men. The mean age was 71±9.4 years, and the mean education period was 7±5.2 years. In brain MRI, white matter hyperintensities were observed in 113 patients (65.3%), and cerebral infarction was present in 57 patients (32.9%). In brain MRA, 88 (50.9%) patients showed more than one stenotic segment in intracranial vessel or proximal ICA and 6 patients (3.5%) were diagnosed with unruptured aneurysm.

The incidence of white matter hyperintensities or stenosis of cerebral vessels on magnetic resonance imaging is very high. Therefore, brain MRI and MRA should be included in diagnostic work up for dementia in patients who are old aged and have multiple vascular risk factors. It would provide clinicians with valuable information in making treatment decisions and prevention of future cerebrovascular accident.