Senile dementia of the Binswanger type: a vascular form of dementia in the elderly
Computed tomography and magnetic resonance imaging in the elderly have demonstrated the common occurrence of deep white-matter lesions in the aging brain. These radiologic lesions (leukoaraiosis) may represent an early marker of dementia. At autopsy, an ischemic periventricular leukoencephalopathy (Binswanger's disease) has been found in most cases. The clinical spectrum of Binswanger's disease appears to range from asymptomatic radiologic lesions to dementia with focal deficits, frontal signs, pseudobulbar palsy, gait difficulties, and urinary incontinence. The name senile dementia of the Binswanger type (SDBT) is proposed for this poorly recognized, vascular form of subcortical dementia. The SDBT probably results from cortical disconnections most likely caused by hypoperfusion. In contrast, multi-infarct dementia is correlated with multiple large and small strokes that cause a loss of over 50 to 100 mL of brain volume. The periventricular white matter is a watershed area irrigated by long, penetrating medullary arteries. Risk factors for SDBT are small-artery diseases, such as hypertension and amyloid angiopathy, impaired autoregulation of cerebral blood flow in the elderly, and periventricular hypoperfusion due to cardiac failure, arrhythmias, and hypotension. The SDBT may be a potentially preventable and treatable form of dementia.
- OSTI ID:
- 5519245
- Journal Information:
- JAMA, J. Am. Med. Assoc.; (United States), Vol. 258:13
- Country of Publication:
- United States
- Language:
- English
Similar Records
Normal-pressure hydrocephalus and the saga of the treatable dementias
Radiation-induced dementia in patients cured of brain metastases
Related Subjects
BRAIN
COMPUTERIZED TOMOGRAPHY
NUCLEAR MAGNETIC RESONANCE
NERVOUS SYSTEM DISEASES
BIOLOGICAL MARKERS
DIAGNOSIS
ARTERIES
BIOMEDICAL RADIOGRAPHY
BLOOD FLOW
ELDERLY PEOPLE
HYPERTENSION
MENTAL DISORDERS
AGE GROUPS
AGED ADULTS
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CENTRAL NERVOUS SYSTEM
DIAGNOSTIC TECHNIQUES
DISEASES
HUMAN POPULATIONS
MAGNETIC RESONANCE
MEDICINE
MINORITY GROUPS
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
POPULATIONS
RADIOLOGY
RESONANCE
SYMPTOMS
TOMOGRAPHY
VASCULAR DISEASES
550602* - Medicine- External Radiation in Diagnostics- (1980-)
550601 - Medicine- Unsealed Radionuclides in Diagnostics