Fazekas Scale for White Matter Hyperintensities
The Fazekas scale is a simple visual rating of white matter hyperintensities on brain MRI, grading periventricular and deep white matter changes separately from 0 to 3. It is the shorthand radiologists reach for when reporting the burden of small-vessel disease in aging, hypertension, and cognitive decline. Its value is standardization and reproducibility across readers rather than precise volume — enough to convey “how much” white matter change is present in a line of a report.
Introduced the 0–3 visual rating of periventricular and deep white-matter hyperintensities (AJR 1987), giving small-vessel-disease burden a reproducible shorthand.
Structured MRI review of atrophy patterns aids differential diagnosis of common dementias, including Alzheimer's disease, frontotemporal lobar degeneration, and vascular cognitive impairment. Specific regional scores and visual rating scales are presented for clinical use.
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