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July 1986

Binswanger's Disease-Reply

Author Affiliations

Department of Neurology Dent Neurological Institute Millard Fillmore Hospital 3 Gates Circle Buffalo, NY 14209
Department of Pathology State University of New York at Buffalo School of Medicine 3435 Main St Buffalo, NY 14214

Arch Neurol. 1986;43(7):641-642. doi:10.1001/archneur.1986.00520070003002

In Reply.  —Rosenberg's statement that we diagnosed Binswanger's disease (subcortical arteriosclerotic encephalopathy) solely on the basis of radiologic findings is incorrect. We made the diagnosis of these cases only after Binswanger's disease was proved at autopsy in one of the patients who had the typical CT and NMR picture during life.1 It seemed perfectly reasonable to assume that most of the other 22 patients with essentially identical CT and NMR images also suffered from Binswanger's disease, and this has been confirmed in another patient in the series who has come to autopsy since the time of our publication. It should be mentioned that Binswanger's disease was proved by autopsies of nine patients whose CT examinations during life revealed changes of leukoencephalopathy that were the same as those seen in our cases, and one of those previous reports was by Rosenberg and colleagues.2-5It is true that periventricular white matter lesions

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