ADD-ONS / SCALES

FAZEKAS scale

Created 25/11/2021, last revision 21/04/2023

  • proposed by Fazekas in 1987 (Fazekas, 1987)
  • a scoring system used for simple assessing of white matter lesions (WML) in the brain on MRI scans
  • the scale distinguishes two regions of white matter:
    • periventricular white matter (PVWM)
    • deep white matter (DWM)
  • each region is assessed in terms of the number, size, and confluence of  lesions
  • it is best assessed on transverse FLAIR or T2-weighted MRI
  • in routine practice, the scale is often replaced by the terms mild, moderate, and severe to describe the severity of lesions
  • periventricular white matter lesions (PVWM) are not always of an ischemic origin (demyelination, subependymal gliosis, ependymitis, etc.)
    • 0 = no lesion
    • 1 = “caps” or pencil-thin lining
    • 2 = smooth “halo”
    • 3 = irregular periventricular signal extending into the deep white matter
  • therefore, only deep white matter (DWM) is assessed when monitoring vascular changes, i.e., FAZEKAS 0-3
    • 0 = no lesion
    • 1 = punctate lesions
    • 2 = beginning confluence
    • 3 = extensive confluent areas
FAZEKAS 1

FAZEKAS 2

Fazekas 3

ARWMC (Age Related White Matter Changes) scale
FAZEKAS scale
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FAZEKAS scale
link: https://www.stroke-manual.com/fazekas/