Fazekas scale (white matter lesions)

The Fazekas scale is used to simply quantify the severity of white matter damage typically attributed to obstruction of small blood vessels.

This classification was proposed by Fazekas  et al. in 1987.

This is the most widely used scale to describe the severity of white matter damage. However, it is sometimes replaced by the use of the qualifiers « mild », « moderate » and « severe » to describe the severity of the lesions,

Classification

The Fazekas scale divides white matter into periventricular and deep white matter, and each region is scored based on the size of the lesions. 

• periventricular white matter
  • 0 = absent
  • 1 = lesion as thin as a pencil
  • 2 = smooth « halo »
  • 3 = irregular periventricular signal extending into deep white matter
• deep white matter
  • 0 = absent
  • 1 = outbreaks
  • 2 = onset of confluence (fusion of lesions)
  • 3 = large areas of confluence

The deep white matter component score, which identifies ischemia in small vessels, is useful in the assessment of patients with possible dementia (eg, Fazekas grade 2).