Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1982 May;45(5):409–417. doi: 10.1136/jnnp.45.5.409

Subcortical arteriosclerotic encephalopathy (Binswanger's type) and cortical infarcts in a young normotensive patient.

L A Loizou, J M Jefferson, W T Smith
PMCID: PMC1083119  PMID: 7086453

Abstract

A 49-year-old normotensive man died after a series of strokes, slowly evolving dementia and personality change occurring over a period of 23 years. CT scan showed large infarcts involving the cortex and white matter of the temporo-occipital areas, small subcortical infarcts and low attenuation in the white matter of the frontal and parietal lobes. Neuropathological examination revealed large cortical and small subcortical infarcts corresponding to the radiological findings as well as degeneration/demyelination of central white matter corresponding to the areas of low attenuation seen on CT. The basic underlying pathological process was hyaline arteriosclerosis and atheroma which diffusely affected the small intracerebral arteries and to a lesser extent the arteries of the circle of Willis. Though usual because of the absence of hypertension, the very early age at onset of the syndrome and the presence of large cortical infarcts this case illustrates the clinical, radiological and neuropathological features of subcortical arteriosclerotic encephalopathy (Binswanger's type).

Full text

PDF
409

Images in this article

410Image
on p.410
411Image
on p.411
412Image
on p.412
412Image
on p.412
413Image
on p.413
413Image
on p.413
413Image
on p.413
414Image
on p.414
414Image
on p.414
415Image
on p.415
415Image
on p.415

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aronson S. M., Perl D. P. Clinical neuropathological conference. A 58-year-old concrete worker was amitted to the hospital because of slowly progressive dementia. Dis Nerv Syst. 1974 Jun;35(6):286–291. [PubMed] [Google Scholar]
  2. Burger P. C., Burch J. G., Kunze U. Subcortical arteriosclerotic encephalopathy (Binswanger's disease). A vascular etiology of dementia. Stroke. 1976 Nov-Dec;7(6):626–631. doi: 10.1161/01.str.7.6.626. [DOI] [PubMed] [Google Scholar]
  3. Caplan L. R., Schoene W. C. Clinical features of subcortical arteriosclerotic encephalopathy (Binswanger disease). Neurology. 1978 Dec;28(12):1206–1215. doi: 10.1212/wnl.28.12.1206. [DOI] [PubMed] [Google Scholar]
  4. De Reuck J., Crevits L., De Coster W., Sieben G., vander Eecken H. Pathogenesis of Binswanger chronic progressive subcortical encephalopathy. Neurology. 1980 Sep;30(9):920–928. doi: 10.1212/wnl.30.9.920. [DOI] [PubMed] [Google Scholar]
  5. FEIGIN I., POPOFF N. NEUROPATHOLOGICAL CHANGES LATE IN CEREBRAL EDEMA: THE RELATIONSHIP TO TRAUMA, HYPERTENSIVE DISEASE AND BINSWANGER'S ENCEPHALOPATHY. J Neuropathol Exp Neurol. 1963 Jul;22:500–511. doi: 10.1097/00005072-196307000-00011. [DOI] [PubMed] [Google Scholar]
  6. Feigin I., Budzilovich G., Weinberg S., Ogata J. Degeneration of white matter in hypoxia, acidosis and edema. J Neuropathol Exp Neurol. 1973 Jan;32(1):125–143. doi: 10.1097/00005072-197301000-00008. [DOI] [PubMed] [Google Scholar]
  7. Hachinski V. C., Lassen N. A., Marshall J. Multi-infarct dementia. A cause of mental deterioration in the elderly. Lancet. 1974 Jul 27;2(7874):207–210. doi: 10.1016/s0140-6736(74)91496-2. [DOI] [PubMed] [Google Scholar]
  8. Janota I. Dementia, deep white matter damage and hypertension: 'Binswanger's disease'. Psychol Med. 1981 Feb;11(1):39–48. doi: 10.1017/s0033291700053265. [DOI] [PubMed] [Google Scholar]
  9. Loizou L. A., Kendall B. E., Marshall J. Subcortical arteriosclerotic encephalopathy: a clinical and radiological investigation. J Neurol Neurosurg Psychiatry. 1981 Apr;44(4):294–304. doi: 10.1136/jnnp.44.4.294. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. OLSZEWSKI J. Subcortical arteriosclerotic encephalopathy. Review of the literature on the so-called Binswanger's disease and presentation of two cases. World Neurol. 1962 May;3:359–375. [PubMed] [Google Scholar]
  11. Okeda R. Morphometrische Verleichsuntersuchungen an Hirnarterien bei Binswangerscher Encephalopathie und Hochdruckencephalopathie. Acta Neuropathol. 1973;26(1):23–43. doi: 10.1007/BF00685521. [DOI] [PubMed] [Google Scholar]
  12. Rosenberg G. A., Kornfeld M., Stovring J., Bicknell J. M. Subcortical arteriosclerotic encephalopathy (Binswanger): computerized tomography. Neurology. 1979 Aug;29(8):1102–1106. doi: 10.1212/wnl.29.8.1102. [DOI] [PubMed] [Google Scholar]
  13. Zeumer H., Schonsky B., Sturm K. W. Predominant white matter involvement in subcortical arteriosclerotic encephalopathy (Binswanger disease). J Comput Assist Tomogr. 1980 Feb;4(1):14–19. doi: 10.1097/00004728-198002000-00003. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES