Binswanger's Disease - Neural Presentation

Neural Presentation

Binswanger's disease is a type of subcortical vascular dementia caused by white matter atrophy to the brain. However, white matter atrophy alone is not sufficient for this disease; evidence of subcortical dementia is also necessary.

The histologic findings are diffuse, irregular loss of axons and myelin accompanied by widespread gliosis, tissue death due to an infarction or loss of blood supply to the brain, and changes in the plasticity of the arteries. The pathologic mechanism may be damage caused by severe atherosclerosis. The onset of this disease is typically between 54 - 66 years of age and the first symptoms are usually mental deterioration or stroke.

The vessels that supply the subcortical white matter come from the vessels that support basal ganglia, internal capsule, and thalamus. It is described as its own zone by and susceptible to injury. Chronic hypertension is known to cause because it changes the tension of the smooth walls vessels and causes changes in the vessel diameter. Arterioles can become permeable resulting in compromise of the blood brain barrier. It has been shown that Binswanger’s disease targets the vessels in this zone of the subcortex, but spares the microvessel and capillaries which may be attributed to a difference between Alzheimer’s and Binswanger’s disease.