CT and MRI may show Bilateral multiple infarcts in the dominant hemisphere and limbic structures Multiple lacunar strokes Periventricular white-matter lesions extending into the deep white matter In Binswanger dementia, leukoencephalopathy in the cerebrum semiovale adjacent to the cortex, often with multiple lacunae affecting structures deep in the gray matter (eg, basal ganglia, thalamic nuclei) In CADASIL and CARASIL, diffuse white matter hyperintensities with ischemic lesions in subcortical regions, including characteristic involvement of the anterior temporal lobe In cerebral amyloid angiopathy, lobar hemorrhage, multiple cortical microhemorrhage or superficial siderosis Key features can help distinguish Alzheimer disease from vascular cognitive impairment and dementia (see table).