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February 1988

Why Not Binswanger's Disease?

Author Affiliations

Department of Medical and Surgical Neurology Texas Tech University School of Medicine Lubbock, TX 79430

Arch Neurol. 1988;45(2):141-142. doi:10.1001/archneur.1988.00520260027013

To the Editor.  —The excellent articles by The University of Western Ontario Dementia Study Group in the January 1987 issue of the Archives have provided much-needed data regarding the significance of periventricular lucencies observed in the elderly by computed tomographic (CT) scan and magnetic resonance imaging (MRI) of the brain. Of particular importance has been the demonstration of intellectual impairment, and motor and reflex changes, in nondemented patients with these white-matter lesions.However, Hachinski et al,1 rather swiftly, dispose of the time-honored name, Binswanger's disease. In the neuropathology literature this term accurately describes an ischemic periventricular leukoencephalopathy, sparing the arcuate U fibers, associated with small-artery cerebrovascular disease, lacunar strokes, and astrocytic gliosis.2,3 Without exception, the postmortem diagnosis concluded in studies4-15 correlating neuropathologic lesions with CT and MRI images of so-called leuko-araiosis, hasNeuropathologic Confirmation of Binswanger's

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