Etiopathogenesis of subcortical arteriosclerotic encephalopathy (Binswanger's type)

• Published in: Japanese Journal of Stroke Vol. 11; no. 4; pp. 309 - 315
• Main Author: Okeda, Riki
• Format: Journal Article
• Language: Japanese
• Published: The Japan Stroke Society 1989
• Subjects: encephalitis subcorticalis chronica prgressiva; subcortical arteriosclerotic encephalopathy (Binswanger)
• ISSN: 0912-0726; 1883-1923
• DOI: 10.3995/jstroke.11.309

Etiopathogenesis of a pathological state called subcortical arteriosclerotic encephalopathy (Binswanger's type) (abbreviated as ESCP), which was at first described by Binswanger in 1894 as one to be differentiated from progressive paralysis, was discussed on the basis of review of the literature and a typical autopsy case. It is now reasonable that ESCP is caused by hypertension-related vascular changes including atherosclerosis of the cerebral medullary arteries, which are more prominent than those of the subarachnoidal arteries of the same case and those of cases of hypertensive cerebral bleeding or cerebral infarct. ESCP, therefore, is considered to be a special form of cerebral diseases caused by systemic hypertension, and should not be lumped together as arteriosclerotic brain diseases. ESCP of the aged seems to be pathologically identical with the so-called “classical” type initiating at presenile age. Moreover, other diseases which present severe demyelination and atrophy of the cerebral white matter due to vascular changes, but etiologically different from ESCP, were also discussed.