Meguro K, Matsushita M, Yoshida R, Otomo E, Yamaguchi S, Nakagawa T, Sasaki H
Department of Geriatric Medicine, Tohoku University School of Medicine.
Nihon Ronen Igakkai Zasshi. 1994 Mar;31(3):226-31. doi: 10.3143/geriatrics.31.226.
A clinicopathological study of senile dementia of Alzheimer's type (SDAT) accompanied by the white matter lesions of Binswanger's type was carried out. Fifty-seven patients, who were diagnosed as suffering from SDAT based on clinical and pathological criteria, were classified into two groups based on the white matter lesions of Binswanger's type. Namely, group 1 consisted of the SDAT patients without any subcortical or white matter lesions (30 cases); group 2 consisted of those with white matter lesions of Binswanger's type (11 cases). The other 9 cases included those with vascular lesions and 4 with some of the same pathological changes found in Parkinson's disease. Clinically, group 2 patients showed subcortical symptoms such as urinary incontinence, Parkinsonian gait, being accompanied by hypertension and arrhythmias. Periventricular lucency (CT) were common in group 2. Macroscopically, both groups showed moderately to severe atrophy, and the width of the corpus callosum of group 2 was narrower than that of group 1. There was no difference in cerebral arteriosclerosis between the groups. In microscopic findings, patients in group 2 showed diffuse distribution of cortical changes such as senile plaques as well as Alzheimer's senile plaques as well as Alzheimer's neurofibrillary tangles while those in group 1 showed various types of diffuse or local distribution. Arteriolosclerosis of the white matter were found in both groups. There was no difference in aortic atherosclerosis and/or heart disease. The complication of white matter lesions of Binswanger's type was not a rare finding in SDAT.
对伴有宾斯旺格型白质病变的阿尔茨海默病型老年痴呆症（SDAT）进行了临床病理研究。57例根据临床和病理标准被诊断为患有SDAT的患者，基于宾斯旺格型白质病变分为两组。即，第1组由无任何皮质下或白质病变的SDAT患者组成（30例）；第2组由患有宾斯旺格型白质病变的患者组成（11例）。另外9例包括有血管病变的患者和4例有帕金森病中发现的一些相同病理变化的患者。临床上，第2组患者表现出皮质下症状，如尿失禁、帕金森步态，伴有高血压和心律失常。第2组中脑室周围透亮区（CT）很常见。大体上，两组均表现为中度至重度萎缩，第2组胼胝体宽度比第1组窄。两组之间脑动脉硬化无差异。在微观发现中，第2组患者表现出皮质变化的弥漫性分布，如老年斑以及阿尔茨海默病老年斑以及阿尔茨海默病神经原纤维缠结，而第1组患者表现出各种类型的弥漫性或局灶性分布。两组均发现白质小动脉硬化。主动脉粥样硬化和/或心脏病无差异。宾斯旺格型白质病变的并发症在SDAT中并非罕见发现。
