Abstract
Progressive subcortical vascular encephalopathy of Binswanger type (PSVE) was observed in 73 cases (4.9%) of the 1500 elderly autopsied cases. Patients were divided into the following three groups according to cerebral white-matter degeneration (WMD). I) Anterior type (25 cases) WMD of fronto-parietal lobes was more remarkable than that of temporo-posterior lobes. II) Posterior type (6 cases) WMD of temporo-posterior lobes was more remarkable than that of fronto-parietal lobes. III) Diffuse type (42 cases) WMD was observed in all lobes. A clinicopathological study was performed on three groups.
Results. 1) In all groups, WMD was related to arteriosclerosis in white matter. 2) Anterior type and diffuse type consisted of most part of elderly PSVE. Posterior type which Binswanger had originally reported was rare. 3) Neuropsychic symptoms were dementia, urinary incontinence, pseudobulbar palsy, psychosis parkinsonism, mutism, etc. No specific symptoms to each group were observed. Hypertension and cardiac disease were frequent complications. 4) Senile changes as much as senile dementia of Alzheimer type were observed in 10% of anterior type and diffuse type. Concerning etiological factors of PSVE, it was considered that arteriosclerosis in white matter was the most important and various complications might accelelate WMD. PSVE was observed in 3.8% of the elderly persons autopsied in 1974-1977 and in 4.9% of the cases in 1978-1983.
