Summergrad P, Peterson B
Psychiatric Service, Massachusetts General Hospital, Boston 02114.
J Geriatr Psychiatry Neurol. 1989 Jul-Sep;2(3):123-33. doi: 10.1177/089198878900200302.
The role of vascular disorders in the pathogenesis of dementia has been controversial. Recent studies suggest that subcortical arteriosclerotic encephalopathy (Binswanger's disease), a disorder of white-matter demyelination associated with narrowing of penetrating medullary arteries and arterioles may affect more than 5% of the population over age 65 years. In part I of this paper, the authors present clinical examples and review the clinical literature, including clinical course and radiologic features. Differential diagnosis and treatment options are reviewed. In part II of this paper we will discuss theories of pathogenesis of subcortical arteriosclerotic encephalopathy and implications for the nosology of dementia.
血管性疾病在痴呆症发病机制中的作用一直存在争议。最近的研究表明，皮质下动脉硬化性脑病（宾斯旺格病），一种与穿通性髓质动脉和小动脉狭窄相关的白质脱髓鞘疾病，可能影响超过5%的65岁以上人群。在本文的第一部分，作者列举了临床实例并回顾了临床文献，包括临床病程和放射学特征。还对鉴别诊断和治疗选择进行了综述。在本文的第二部分，我们将讨论皮质下动脉硬化性脑病的发病机制理论及其对痴呆症分类学的影响。
