Arteriolosclerosis in the cerebral white matter in Binswanger type vascular dementia

We evaluated the arteriolar adventitial proliferative rate (AP) in the white matter of 118 autopsied brains (58 control cases, C group; 43 hypertensive cases, HT group; and 17 Binswanger type vascular dementia cases, VD group), together with the sclerotic rate (AS) of the middle cerebral artery. In the C group, AP increased with age, advancing rapidly in subjects over 80 years old. In contrast, AS increased slowly in subjects over 80 years old. There was no difference between AS in the VD and HT groups, while the VD group showed a greater AP than did the HT group. The results of CT scans performed in 45 cases revealed that while AP demonstrated a significant correlation with leukoaraiosis(LA), AS showed no such correlation. Our results suggest that arteriolar adventitial proliferation plays a more important role in the onset of Binswanger type vascular dementia and the progress of LA. We also observed a strong relationship between ischemic changes in the cerebral white matter and arteriolar adventitial proliferation. (author)