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February 1988

Why Not Binswanger's Disease?-Reply

Author Affiliations

For the University of Western Ontario Dementia Study Group Department of Clinical Neurological Sciences University Hospital PO Box 5339 Postal Station "A" London, Ontario, Canada N6A 5A5

Arch Neurol. 1988;45(2):142-143. doi:10.1001/archneur.1988.00520260028014

In Reply.  —We thank Dr Awad, Professor Hauw, Drs Roullet, Gray, and Dubas, and Dr Román for their kind comments and interest regarding the articles from the University of Western Ontario Dementia Study. Their letters illustrate the need for a noncommittal descriptive term for the white-matter changes seen on computed tomography (CT) and magnetic resonance imaging (MRI) of the brain. Dr Awad believes that leuko-araiosis represents "état criblé" and "subcortical encephalomalacia"; Professor Hauw thinks that leuko-araiosis represents the "brain interstitial atrophy" described by Durand-Fardel, who specifically distinguished it from "état criblé" and brain encephalomalacia, and Dr Román argues that leuko-araiosis represents "Binswanger's disease." These possibilities cannot all be exclusively right!Dr Awad asks what signal intensity is required to qualify as "araiosis." The answer depends on the scanner and technique used and emphasizes further that accurate definition and description not only of patients but also of methods is required in order to

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