Progress Review Binswanger's Disease: A Review

BINSWANGER'S disease (BD) is characterized by cerebrovascular lesions in the hemispheral white matter. Interest in BD has been stimulated recently by reports of low density in the periventricular white matter on computerized tomography (CT) and magnetic resonance imaging (MRI) in elderly patients with dementia. This radiographic appearance also is common in asymptomatic patients. To better define the clinical features associated with the characteristic white matter lesions of BD, we reviewed the international literature from 1912 to the present for pathologically verified cases accompanied by relatively complete clinical descriptions. Twenty-one reports with 46 patients were found and, with a case of our own, are summarized in Table 1. The initial symptoms, rate of progression, presence of dementia, and other clinical features were variable. The pathologic features of these 47 cases were, by contrast, uniform and constitute the best basis for defining BD as a disease. The precise cause of the characteristic, presumably ischemic, white matter changes is unknown.