White matter lucencies on computed tomography, subacute arteriosclerotic encephalopathy (Binswanger's disease), and blood pressure.
White matter lucencies on computed tomography, subacute arteriosclerotic encephalopathy (Binswanger's disease), and blood pressure.
复制标题
计算机断层扫描显示白质透亮、亚急性动脉硬化性脑病（宾斯旺格病）和血压。
作者：
B. McQuinn;D. O'leary
在一年中，在一家初级三级私立医院进行的1,643例颅脑计算机断层扫描（CT）扫描中，11例（0.67%）显示弥漫性融合白质透光率低于30 Hounsfield单位。通过回顾性分析，11例患者中至少有4例痴呆。其中3例有Binswanger病的临床证据，其特征为进行性痴呆、大小便失禁、可变假球征以及急性和亚急性运动缺陷。另外两名患者只有短暂性脑缺血发作或腔隙性中风；2例晕厥；我有多发性硬化症。其余患者无神经症状。在这个小型回顾性系列中，CT改变的严重程度并不能区分临床Binswanger综合征患者和神经症状较轻的患者。11例患者中有10例血压调节紊乱——高血压、不稳定收缩压、体位性低血压或这些因素的组合。CT改变的严重程度与血压不稳定的相关性比与临床脑病的相关性更明显。然而，无症状的成年患者有不明原因的CT白质低密度和血压障碍，可能有继发亚急性动脉硬化性脑病的风险。
Of 1,643 cranial computed tomography (CT) scans done in a primary-tertiary care private hospital over a 1-year period, 11 (0.67%) showed diffuse confluent white matter lucencies of less than 30 Hounsfield units. By retrospective analysis, at least 4 of the 11 were demented. Of these, 3 had clinical evidence of Binswanger's disease--characterized by progressive dementia, incontinence, variable pseudobulbar signs, and acute and subacute motor deficits. Two additional patients suffered only transient ischemic attacks or lacunar strokes; 2 had syncope; 1 had multiple sclerosis. The remaining patients were neurologically asymptomatic. In this small retrospective series, the severity of CT changes did not distinguish the patients with clinical Binswanger's syndrome from neurologically less symptomatic patients. Ten of the eleven patients had disordered blood pressure regulation--hypertension, labile systolic pressure, orthostatic hypotension, or a combination of these factors. The severity of CT changes correlated more clearly with blood pressure instability than with clinical encephalopathy. Asymptomatic adult patients with unexplained CT white matter hypodensity and blood pressure disorders may, however, be at risk for the development of subsequent subacute arteriosclerotic encephalopathy.