[Difference of cerebral arteriolosclerosis between the deep and subcortical white matter in normal aging and vascular dementia of Binswanger type].

A comparative pathological study of arteriosclerosis was conducted between the deep white matter (M1) and the subcortical white matter (M2) to investigate the difference in the arteriolar changes in normally-aging individuals and those presenting vascular dementia. The arterioles (20-100 microns in outer diameter) of 95 autopsied brains were examined (56 control cases; C group, 24 hypertensive cases; HT group, and 15 Binswanger type vascular dementia cases; VD group). In C group, the primary pathological change was adventitial proliferation (AP), which was significantly more pronounced in M1 than in M2. AP in M1 was found to have advanced promptly with aging, while AP in M2 advanced mildly. AP in M1 was much more pronounced in HT group than in the age-matched C group, but little difference in M2 was observed between the two groups. AP in VD group was more pronounced in M2 than in M1 compared with HT group. These findings indicate that AP in M1 occurs prior to that in M2 in the process of normal aging, and that AP, in M2 as well as in M1, may play an important role in the pathogenesis of Binswanger type vascular dementia.