Binswanger's encephalopathy: a review

Summary Binswanger's encephalopathy is reviewed in respect to history, computed tomography, magnetic resonance imaging, epidemiology, pathology, clinical picture, laboratory findings, differential diagnosis, and treatment. The various viewpoints on the pathogenesis of the process are discussed, in particular the role of ischemia, vascular disease, high blood pressure, lacunar infarction, hypoxia, edema, and hydrocephalus. The white matter hypomyelination of congophilic angiopathy and Alzheimer's disease should provide clues. A unifying hypothesis has not been attained.Abbreviations AD Alzheimer's disease - BE Binswanger's encephalopathy - BP blood pressure - CA congophilic angiopathy - CSF cerebrospinal fluid - CT computed tomography - EEG electroencephalography - HU Hounsfield units - ISL incidental subcortical lesions - LD low density - MR magnetic resonance imaging - NPH normal pressure hydrocephalus - PV periventricular - PVH periventricular hyperintensity in MR, including capping and rimming - PVLD periventricular low density in CT - PVWM periventricular white matter - TIA transient ischemic attack - UBOs unidentified bright objects - U fibers arcuate fibers - WM white matter - WMHF white matter hyperintense foci in MR - WMLD white matter low density