Kinkel W R, Jacobs L, Polachini I, Bates V, Heffner R R
Arch Neurol. 1985 Oct;42(10):951-9. doi: 10.1001/archneur.1985.04060090033010.
Twenty-three elderly patients were found to have a consistent pattern of leukoencephalopathy by computed tomography and nuclear magnetic resonance imaging. Eight patients presented with vague, nonspecific symptoms and had no neurologic deficits. The other 15 patients had neurologic deficits that presented in one of three ways: stroke, seven patients; slowly progressive dementia and gait disturbance, five patients; or slowly progressive dementia alone, three patients. Risk factors for arteriosclerosis (hypertension, diabetes) were present in 18 patients (78%). The necropsy of one patient revealed arteriosclerotic vasculopathy characteristic of subcortical arteriosclerotic encephalopathy (SAE) or Binswanger's disease. Subcortical arteriosclerotic encephalopathy may be a relatively common affliction of elderly patients, most of whom have risk factors for arteriosclerosis. The modes of presentation and associated clinical signs are variable, and more than one third may have no neurologic deficit. In some cases SAE overlaps with normal pressure hydrocephalus by clinical and neuroimaging criteria. Some patients with normal pressure hydrocephalus who do not respond to ventricular shunting may actually have SAE.
通过计算机断层扫描和核磁共振成像发现，23名老年患者存在一致的白质脑病模式。8名患者表现出模糊、非特异性症状，且无神经功能缺损。其他15名患者的神经功能缺损表现为以下三种方式之一：中风，7名患者；缓慢进展性痴呆和步态障碍，5名患者；或仅缓慢进展性痴呆，3名患者。18名患者（78%）存在动脉硬化风险因素（高血压、糖尿病）。一名患者的尸检显示出皮质下动脉硬化性脑病（SAE）或宾斯旺格病的动脉硬化性血管病变特征。皮质下动脉硬化性脑病可能是老年患者相对常见的疾病，其中大多数人有动脉硬化风险因素。其呈现方式和相关临床体征各不相同，超过三分之一的患者可能没有神经功能缺损。在某些情况下，根据临床和神经影像学标准，SAE与正常压力脑积水重叠。一些对脑室分流无反应的正常压力脑积水患者实际上可能患有SAE。
