Englund Elisabet
Department of Pathology, Division of Neuropathology, University of Lund, Sweden.
Cerebrovasc Dis. 2002;13 Suppl 2:11-5. doi: 10.1159/000049144.
The white matter is an important locus for tissue damage in vascular cognitive impairment and white matter lesions often dominate over gray matter changes. The spectrum of ischemic white matter lesions histopathologically represents focal and diffuse lesions, the most common form being the combination of both, in varying proportions. In the combined pathology, the diffuse lesion represents a gradient zone of damage towards surrounding normal tissue and may hold over 200 times the volume of an identified focal lesion, the lacunar infarct. Pathogenetically, the focal lesion results from the acute reaction to regional ischemia, while the diffuse white matter lesion represents the adjustment to altered perfusional and physiological conditions within the tissue.
白质是血管性认知障碍中组织损伤的重要部位，白质病变通常比灰质变化更为显著。缺血性白质病变的组织病理学谱表现为局灶性和弥漫性病变，最常见的形式是两者以不同比例混合存在。在混合病理中，弥漫性病变代表向周围正常组织的损伤梯度区，其体积可能是已识别的局灶性病变（腔隙性梗死）的200多倍。从发病机制上讲，局灶性病变是由局部缺血的急性反应导致的，而弥漫性白质病变则代表对组织内灌注和生理条件改变的适应性变化。
