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e-CASES: Fazekas scale for WM lesions

Dr Antoine Micheau , Clinique du Parc - Castelnau Le Lez - Montpellier , Montpellier , Herault , France

On MR, white matter hyperintensities (WMH) and lacunes - both of which are frequently observed in the elderly - are generally viewed as evidence of small vessel disease.

The Fazekas-scale provides an overall impression of the presence of WMH in the entire brain.

It is best scored on transverse FLAIR or T2-weighted images.


  Periventricular Lesions
0 No lesions
1 Caps or thin line
2 Smooth halo
3 Extension into the white matter
  White matter lesions
0 No lesions
1 Punctate foci
2 Beginning confluence of foci
3 Large confluent areas