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Binswanger’s Disease: Progressive Subcortical Encephalopathy or Multi-Infarct Dementia?

Published online by Cambridge University Press:  18 September 2015

Kewei Huang*
Affiliation:
Neuropathology Laboratory, Chinese PLA General Hospital, Beijing, People’s Republic of China
Lijuan Wu
Affiliation:
Department of Neurology, Beijing Medical College, Beijing, People’s Republic of China
Yi Luo
Affiliation:
Neuropathology Laboratory, Chinese PLA General Hospital, Beijing, People’s Republic of China
*
Neuropathology Laboratory, Chinese PLA General Hospital, Beijing, People’s Republic of China
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Abstract:

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Since Binswanger’s description of subcortical arteriosclerotic encephalopathy in 1894, numerous cases have been reported. Several authors doubt the validity of this malady, although the majority consider it to be a disease entity. We report seven cases with this type of pallor of myelin, only two of which are accompanied by a history of dementia. Among the seven cases, two had arteriosclerosis of penetrating arteries and arterioles in cerebral white matter. Electron microscopy showed splitting of myelin sheaths, probably the result of edema. In reviewing the blood supply of the cerebral white matter, we conclude that no pathological alterations of medullary branches of the cerebral arteries, the same vessels supplying the white matter, can give rise to such diffuse pallor of white matter and spare the arcuate fibres. This pallor can only be due to cerebral edema, most likely of hypoxic-ischemic, hypotensive, or acidotic origin. We also contend that arteriosclerosis can only cause dementia through multiple infarcts or lacunae, if it indeed leads to dementia.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1985

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