Enfermedad de binswanger: evolucion de las ideas y propuesta de un tripode diagnóstico

Vega, Marcelo Gabriel; Faccio, Enrique José

doi:10.1590/S0004-282X1995000300027

Resúmenes

Estudamos a evolução do conceito de doença de Binswanger a partir de 1894, ano de sua descrição inicial. Observamos que, posteriormente a uma fase com escassos relatos, com a introdução da tomografia computadorizada de crânio, há uma fase de sobrediagnóstico e de perda dos conceitos básicos, levando a confusão na literatura. Propomos a utilização de um tripé diagnóstico - clínico, radiológico e anatomo-patológico - que ajudará o correto posicionamento médico perante essa doença.

Binswanger; leucoaraiose; substância branca; demência

We review the evolution of the concept of Binswanger's disease from his original description in 1894 to our days. We emphasize the conceptual impact caused by CAT scan. Finally, we propose a diagnostic triad based on clinical, neuropathological and radiological trends. We believe Binswanger's disease has a clear identity despite the lack of solid diagnostic criteria.

Binswanger; leukoaraiosis; white matter; dementia

Binswanger; leucoaraiose; substância branca; demência

Binswanger; leukoaraiosis; white matter; dementia

Enfermedad de binswanger. Evolucion de las ideas y propuesta de un tripode diagnóstico

Binswanger's disease: thought's evolution and a proposal of diagnostic triad

Marcelo Gabriel Vega^I; Enrique José Faccio^II

^IDoctor en Medicina (Universidad Nacional de Buenos Aires), Serviço de Neurologia da Santa Casa de Misericórdia de Belo Horizonte, Faculdade de Ciências Médicas de Minas Gerais

^IIDoctor en Medicina (Universidad Nacional de Buenos Aires), Jefe del Laboratorio de Anatomia Patológica del Hospital Nacional José T. Borda, Argentina

RESUMO

Estudamos a evolução do conceito de doença de Binswanger a partir de 1894, ano de sua descrição inicial. Observamos que, posteriormente a uma fase com escassos relatos, com a introdução da tomografia computadorizada de crânio, há uma fase de sobrediagnóstico e de perda dos conceitos básicos, levando a confusão na literatura. Propomos a utilização de um tripé diagnóstico - clínico, radiológico e anatomo-patológico - que ajudará o correto posicionamento médico perante essa doença.

Palavras-chave: Binswanger, leucoaraiose, substância branca, demência.

SUMMARY

We review the evolution of the concept of Binswanger's disease from his original description in 1894 to our days. We emphasize the conceptual impact caused by CAT scan. Finally, we propose a diagnostic triad based on clinical, neuropathological and radiological trends. We believe Binswanger's disease has a clear identity despite the lack of solid diagnostic criteria.

Key words:Binswanger, leukoaraiosis, white matter, dementia.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 3-janeiro-1995.

Nota: Este estudio forma parte de la Tesis de Doctorado de uno de nosotros (MGV). La orientación del Dr. Enrique Faccio fué fundamental. Su ausencia temprana se hace sentir en todos aquellos que tuvimos la oportunidad de compartir el dia a dia con su sabiduría y su cariño.

Dr. Marcelo Gabriel Vega - Rua Ceará 567, 5º Andar - 30150-310 Belo Horizonte MG - Brasil.

1. Acevedo M. Demencia por reblandecimientos múltiples subcorticales. Rev Soc Med Arg 1909, 17:873-915.
2. Ali Cherif A, Labrecque R, Pellisier JF, Poncet M, Boudouresques J. Encéphalopathie s sous-corticale de Binswanger: etude d'un cas comportant une atteinte hémispherique gauche nettement prédominant. Rev Neurol (Paris) 1979, 135:665-678.
3. Alzheimer A. Die Seelenstörungen auf arteriosklerotischer Grundlage. Allgemeine Z Psychiatrie Psichochger Med 1902, 59:665-671.
4. Aronson S, Perl DP. Clinical neuropathological conference. Dis Nerv Syst 1974, 35:286-291.
5. Awad IA, Johnson PC. Spetzler RF, Hodak JA. Incidental subcortical lesions identified on Magnetic Resonance Imaging in the elderly. II: Postmortem pathological correlations Stroke 1986, 17:1090-1097.
6. Babikian V, Ropper A. Binswanger disease: a review. Stroke 1987, 18:2-12.
7. Bennet DA, Wilson RS, Gilley DW, Fox JH. Clinical diagnosis of Binswanger's disease J Neurol Neurosurg Psychiatry 1990, 54:961-965.
8. Biemond A. On Binswanger's subcortical arteriosclerotic encephalopathy and the possibility of its clinical recognition. Psychiat Neurol Neurochir 1970, 73:413-417.
9. Binswanger O. Die Abgrenzung der allgemeine progressiven Paralyse. Berliner Klin Wochenschr 1894, 31: 1103-1105. 1137-1139, 1180-1186.
10. Bogousslavsky J. Leucoencéphalopathie, leukoaraiose et infarctus cérébraux. Rev Neurol (Paris) 1988, 144:11-17.
11. Brun A, Englund E. White matter in dementia of the Alzheimer type: a pathoanatomical study. Ann Neurol 1986, 19:253-262.
12. Brust JMC. Vascular dementia is overdiagnosed. Arch Neurol 1988, 45:799-801.
13. Bucholz L Ueber die Geistesstörungen bei Arteriosklerose und ihre Bezienhugen zu den psychischen Erkrankungen des Senium. Arch Psych Nervenkrank 1905, 39:499-532.
14. Caplan L. Binswanger's disease. In Frederiks JAM (ed). Neurobehavoural disorders. Handbook of Clinical Neurology. Amsterdam: Elsevier, 1985, Vol 2, 317-320.
15. Caplan L, Schoene WC. Clinical features of subcortical arteriosclerotic encephalopathy (Binswanger disease). Neurology 1978, 28:1206-1215.
16. Davison C. Progressive sucortical encephalopathy (Binswanger's disease) J Neuropath Exp Neurol 1942, 1:42-48.
17. De Reuck J. The cortico-subcortical arterial angioarchitecture in the human brain. Acta Neurol Belg 1972, 323-329.
18. Dimitri V, Aranovich J. Sobre los aspectos leucoencefalósicos de la arteriosclerosis cerebral. Rev Neurol Bs As 1945, 10:290-305.
19. Earnest MP, Fahn S, Karp JH, Rowland LP. Normal pressure hydrocephalus and hypertensive cerebrovascular disease. Arch Neurol 1974, 31:262-266.
20. Erkinjuntti T, Ketonen L, Sulkawa R, Sipponen J, Vuorialho M, Iivanaine M. Do white matter changes on MRI and CT differentiate vascular dementia from Alzheimer's disease? J Neurol Neurosurg Psychiatry 1987,50: 37-42.
21. Farnell FJ, Globus JH. Chronic progressive vascular subcortical encephalopathy: chronic progressive subcortical encephalitis of Binswanger. Arch Neurol Psychiat 1932, 27:593-603.
22. Garcin R, Lapresle J, Lyon G. Encéphalopathie sous corticale chronique de Binswanger: étude anatomo-clinique de trois observations. Rev Neurol (Paris) 1960, 102:423-439.
23. George AE, de León MJ, Gentes CI, Miller J, London E, Budzilovich GN, Ferris SH, Chase N. Leukoencephalopathy in normal and pathologic aging: 1. CT of brain lucencies. AJNR 1986, 7:561-566.
24. George AE, de León MJ, Kalnin A, Rosner L, Goodgold A, Chase N. Leukoencephalopathy in normal and pathological aging: 2. MRI of brain lucencies AJNR 1986, 7:567-571.
25. Goto K, Ishii N, Fukasawa H. Diffuse white matter disease in the geriatric population: clinical, neuropathological and CT study. Radiology 1981, 141:687-695.
26. Hachinski VC, Potter P, Merskey H. Leuko-araiosis. Arch Neurol 1987, 44:21-23.
27. Ishino H, Higashi H, Hayahara T, Ikeda H, Otsuki S. A case of subcortical arteriosclerotic encephalopathy (Binswanger's disease). Folia Psychiat Neurol Jap 1972, 26:39-44.
28. Jakob Ch, Moyano BA. La anatomia patológica de la arteriosclerosis cerebral. Rev Asoc Med Arg 1938, 4:244-254.
29. Jellgersma HC. A case of encephalopathia subcorticalis chronica (Binswanger's disease). Psychiat Neurol (Basel) 1964, 147:81-89.
30. Jellinger K, Newmaier E. Progressive subcorticale vasculare Encephalopathie Binswanger: eine klinisch neuropathologische studie. Arch Psych Zeitschrift Ges Neurol 1964, 205: 523-554.
31. Kashida H. Uber Gehirnarteriosklerose des früen Alters und über die kombination von corticalen, pyramidalen, und extrapyramidalen symptomen bei der Gehirnarteriosklerose. Zeitsch Ges Neurol Psych 1925, 25:659-702.
32. Kinkel WR, Jacobs L, Polachini I, Bates V, Heffner RR. Subcortical arteriosclerotic encephalopathy (Binswanger's disease) computed tomography, nuclear magnetic resonance and clinical correlations. Arch Neurol 1985, 42: 951-959.
33. Ladame C. Encéphalite sous-corticale chronique; un cas de psychose d'origine artérioscléreuse. Encephale 1912,7:13-39.
34. Loeb C. Vascular dementias. In Frederiks JAM (ed) Neurobehavioural disorders. Handbook of Clinical Neurology. Amsterdam: Elsevier,. 1985, Vol 2.
35. Loizou LA, Kendall BE, Marshall J. Subcortical arteriosclerotic encephalopathy: a clinical and radiological investigation. J Neurol Neurosurg Psychiatry 1981,44:294-304.
36. Lotz PR, Ballinger WE Jr, Quisling RG. Subcortical arteriosclerotic encephalopathy: CT spectrum and pathologic correlation. AJNR 1986, 7:817-822.
37. Mikol J. Maladie de Binswanger et formes aparentées. Rev Neurol (Paris)1968, 118:111-132.
38. Neumannn MA Chronic progressive subcortical encephalopathy: report of a case. J Gerontol 1947, 2:57-64.
39. Nissl F. Zur Kasuistik der arteriosklerotischen Demenz (ein Fall von sog "Encephalitis subcorticalis"). Zeitschr Ges Neurol Psych 1920, 19:438-453.
40. Okeda R. Morphometrische vergleich Untersuchungen an Hirnarterien bei Binswangerscher Encephalopathie und Hochdruckencephalopathie. Acta Neuropatol (Berlin) 1973, 26:22-43.
41. Olszewski J. Subcortical arteriosclerotic encephalopathy: review of the literature on the so called Binswanger's disease and presentation of two cases. World Neurol 1962, 3:359-375.
42. Orlando R, Orlando JC. Leucoencefalosis tipo Binswanger. Acta Neuropsiquiat Arg 1955, 1:186-195.
43. Rezek DL, Morris JC, Fulling KH, Gado MH. Periventricular white matter lucencies in senile dementia of the Alzheimer's type and in normal aging. Neurology 1987, 37: 1365-1368.
44. Rosenberg GA, Kornfeld M, Stovring J, Bicknell JM. Subcortical arteriosclerotic encephalopathy (Binswanger): computerized tomography. Neurology 1979, 29:1102-1106.
45. Sze G, De Armond SJ, Brant Zawadzki M, Davis RL, Norman D, Newton HT. Foci of MRI signal (pseudo-lesions) anterior to the frontal horns: histologic correlations of a normal finding. AJNR 1986, 7:381-387.
46. Valentine AR, Moseley IF, Kendall BE. White matter abnormality in cerebral atrophy clinicoradiological correlations. J Neurol Neurosurg Psychiatry 1980, 43:139-142.
47. Van Bogaert L, Martin JJ. Analyse critique de la pathologie de l'angiomatose cérébromeningée diffuse non calcifiante et de l'encephalopathie de Binswanger. J Neurol Sci 1971, 14:301-314.
48. Vega MG, Faccio EJ. Acerca de las alteraciones de la sustância blanca observadas en condiciones normales y patológicas en sujetos de edad avanzada. Tesis de Doctorado. Universidad Nacional de Buenos Aires, 1991.
49. Yamanouchi H, Sugiura S, Tomonaga M. Decrease in nerve fibres in cerebral white matter in progressive subcortical encephalopathy of Binswanger type: an electron microscopy study. J Neurol 1989, 7:382-387
50. Yvonneau M, Vital C, Lafforgue J, Kinsala MS. L'encephalopathie sous corticale chronique de Binswanger: etude anatomo-clinique d'une observation. Bordeaux Med 1969, 5:1135-1141.
51. Zimmermann RD, Fleming CA, Lee BCP, Saint-Louis LA, Deck MDF. Periventricular hyperintensities as seen by magnetic resonance: prevalence and significance. AJNR 1986, 7:13-20.
52. Zulch KJ Conceptions nouvelles concernant la pathogénie de 1'ischemie cérébrale. Ann Radiol 1963, 6:7-14.

Fechas de Publicación

Publicación en esta colección
06 Ene 2011
Fecha del número
Set 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Acevedo M. Demencia por reblandecimientos múltiples subcorticales. Rev Soc Med Arg 1909, 17:873-915.

[2] 2. Ali Cherif A, Labrecque R, Pellisier JF, Poncet M, Boudouresques J. Encéphalopathie s sous-corticale de Binswanger: etude d'un cas comportant une atteinte hémispherique gauche nettement prédominant. Rev Neurol (Paris) 1979, 135:665-678.

[3] 3. Alzheimer A. Die Seelenstörungen auf arteriosklerotischer Grundlage. Allgemeine Z Psychiatrie Psichochger Med 1902, 59:665-671.

[4] 4. Aronson S, Perl DP. Clinical neuropathological conference. Dis Nerv Syst 1974, 35:286-291.

[5] 5. Awad IA, Johnson PC. Spetzler RF, Hodak JA. Incidental subcortical lesions identified on Magnetic Resonance Imaging in the elderly. II: Postmortem pathological correlations Stroke 1986, 17:1090-1097.

[6] 6. Babikian V, Ropper A. Binswanger disease: a review. Stroke 1987, 18:2-12.

[7] 7. Bennet DA, Wilson RS, Gilley DW, Fox JH. Clinical diagnosis of Binswanger's disease J Neurol Neurosurg Psychiatry 1990, 54:961-965.

[8] 8. Biemond A. On Binswanger's subcortical arteriosclerotic encephalopathy and the possibility of its clinical recognition. Psychiat Neurol Neurochir 1970, 73:413-417.

[9] 9. Binswanger O. Die Abgrenzung der allgemeine progressiven Paralyse. Berliner Klin Wochenschr 1894, 31: 1103-1105. 1137-1139, 1180-1186.

[10] 10. Bogousslavsky J. Leucoencéphalopathie, leukoaraiose et infarctus cérébraux. Rev Neurol (Paris) 1988, 144:11-17.

[11] 11. Brun A, Englund E. White matter in dementia of the Alzheimer type: a pathoanatomical study. Ann Neurol 1986, 19:253-262.

[12] 12. Brust JMC. Vascular dementia is overdiagnosed. Arch Neurol 1988, 45:799-801.

[13] 13. Bucholz L Ueber die Geistesstörungen bei Arteriosklerose und ihre Bezienhugen zu den psychischen Erkrankungen des Senium. Arch Psych Nervenkrank 1905, 39:499-532.

[14] 14. Caplan L. Binswanger's disease. In Frederiks JAM (ed). Neurobehavoural disorders. Handbook of Clinical Neurology. Amsterdam: Elsevier, 1985, Vol 2, 317-320.

[15] 15. Caplan L, Schoene WC. Clinical features of subcortical arteriosclerotic encephalopathy (Binswanger disease). Neurology 1978, 28:1206-1215.

[16] 16. Davison C. Progressive sucortical encephalopathy (Binswanger's disease) J Neuropath Exp Neurol 1942, 1:42-48.

[17] 17. De Reuck J. The cortico-subcortical arterial angioarchitecture in the human brain. Acta Neurol Belg 1972, 323-329.

[18] 18. Dimitri V, Aranovich J. Sobre los aspectos leucoencefalósicos de la arteriosclerosis cerebral. Rev Neurol Bs As 1945, 10:290-305.

[19] 19. Earnest MP, Fahn S, Karp JH, Rowland LP. Normal pressure hydrocephalus and hypertensive cerebrovascular disease. Arch Neurol 1974, 31:262-266.

[20] 20. Erkinjuntti T, Ketonen L, Sulkawa R, Sipponen J, Vuorialho M, Iivanaine M. Do white matter changes on MRI and CT differentiate vascular dementia from Alzheimer's disease? J Neurol Neurosurg Psychiatry 1987,50: 37-42.

[21] 21. Farnell FJ, Globus JH. Chronic progressive vascular subcortical encephalopathy: chronic progressive subcortical encephalitis of Binswanger. Arch Neurol Psychiat 1932, 27:593-603.

[22] 22. Garcin R, Lapresle J, Lyon G. Encéphalopathie sous corticale chronique de Binswanger: étude anatomo-clinique de trois observations. Rev Neurol (Paris) 1960, 102:423-439.

[23] 23. George AE, de León MJ, Gentes CI, Miller J, London E, Budzilovich GN, Ferris SH, Chase N. Leukoencephalopathy in normal and pathologic aging: 1. CT of brain lucencies. AJNR 1986, 7:561-566.

[24] 24. George AE, de León MJ, Kalnin A, Rosner L, Goodgold A, Chase N. Leukoencephalopathy in normal and pathological aging: 2. MRI of brain lucencies AJNR 1986, 7:567-571.

[25] 25. Goto K, Ishii N, Fukasawa H. Diffuse white matter disease in the geriatric population: clinical, neuropathological and CT study. Radiology 1981, 141:687-695.

[26] 26. Hachinski VC, Potter P, Merskey H. Leuko-araiosis. Arch Neurol 1987, 44:21-23.

[27] 27. Ishino H, Higashi H, Hayahara T, Ikeda H, Otsuki S. A case of subcortical arteriosclerotic encephalopathy (Binswanger's disease). Folia Psychiat Neurol Jap 1972, 26:39-44.

[28] 28. Jakob Ch, Moyano BA. La anatomia patológica de la arteriosclerosis cerebral. Rev Asoc Med Arg 1938, 4:244-254.

[29] 29. Jellgersma HC. A case of encephalopathia subcorticalis chronica (Binswanger's disease). Psychiat Neurol (Basel) 1964, 147:81-89.

[30] 30. Jellinger K, Newmaier E. Progressive subcorticale vasculare Encephalopathie Binswanger: eine klinisch neuropathologische studie. Arch Psych Zeitschrift Ges Neurol 1964, 205: 523-554.

[31] 31. Kashida H. Uber Gehirnarteriosklerose des früen Alters und über die kombination von corticalen, pyramidalen, und extrapyramidalen symptomen bei der Gehirnarteriosklerose. Zeitsch Ges Neurol Psych 1925, 25:659-702.

[32] 32. Kinkel WR, Jacobs L, Polachini I, Bates V, Heffner RR. Subcortical arteriosclerotic encephalopathy (Binswanger's disease) computed tomography, nuclear magnetic resonance and clinical correlations. Arch Neurol 1985, 42: 951-959.

[33] 33. Ladame C. Encéphalite sous-corticale chronique; un cas de psychose d'origine artérioscléreuse. Encephale 1912,7:13-39.

[34] 34. Loeb C. Vascular dementias. In Frederiks JAM (ed) Neurobehavioural disorders. Handbook of Clinical Neurology. Amsterdam: Elsevier,. 1985, Vol 2.

[35] 35. Loizou LA, Kendall BE, Marshall J. Subcortical arteriosclerotic encephalopathy: a clinical and radiological investigation. J Neurol Neurosurg Psychiatry 1981,44:294-304.

[36] 36. Lotz PR, Ballinger WE Jr, Quisling RG. Subcortical arteriosclerotic encephalopathy: CT spectrum and pathologic correlation. AJNR 1986, 7:817-822.

[37] 37. Mikol J. Maladie de Binswanger et formes aparentées. Rev Neurol (Paris)1968, 118:111-132.

[38] 38. Neumannn MA Chronic progressive subcortical encephalopathy: report of a case. J Gerontol 1947, 2:57-64.

[39] 39. Nissl F. Zur Kasuistik der arteriosklerotischen Demenz (ein Fall von sog "Encephalitis subcorticalis"). Zeitschr Ges Neurol Psych 1920, 19:438-453.

[40] 40. Okeda R. Morphometrische vergleich Untersuchungen an Hirnarterien bei Binswangerscher Encephalopathie und Hochdruckencephalopathie. Acta Neuropatol (Berlin) 1973, 26:22-43.

[41] 41. Olszewski J. Subcortical arteriosclerotic encephalopathy: review of the literature on the so called Binswanger's disease and presentation of two cases. World Neurol 1962, 3:359-375.

[42] 42. Orlando R, Orlando JC. Leucoencefalosis tipo Binswanger. Acta Neuropsiquiat Arg 1955, 1:186-195.

[43] 43. Rezek DL, Morris JC, Fulling KH, Gado MH. Periventricular white matter lucencies in senile dementia of the Alzheimer's type and in normal aging. Neurology 1987, 37: 1365-1368.

[44] 44. Rosenberg GA, Kornfeld M, Stovring J, Bicknell JM. Subcortical arteriosclerotic encephalopathy (Binswanger): computerized tomography. Neurology 1979, 29:1102-1106.

[45] 45. Sze G, De Armond SJ, Brant Zawadzki M, Davis RL, Norman D, Newton HT. Foci of MRI signal (pseudo-lesions) anterior to the frontal horns: histologic correlations of a normal finding. AJNR 1986, 7:381-387.

[46] 46. Valentine AR, Moseley IF, Kendall BE. White matter abnormality in cerebral atrophy clinicoradiological correlations. J Neurol Neurosurg Psychiatry 1980, 43:139-142.

[47] 47. Van Bogaert L, Martin JJ. Analyse critique de la pathologie de l'angiomatose cérébromeningée diffuse non calcifiante et de l'encephalopathie de Binswanger. J Neurol Sci 1971, 14:301-314.

[48] 48. Vega MG, Faccio EJ. Acerca de las alteraciones de la sustância blanca observadas en condiciones normales y patológicas en sujetos de edad avanzada. Tesis de Doctorado. Universidad Nacional de Buenos Aires, 1991.

[49] 49. Yamanouchi H, Sugiura S, Tomonaga M. Decrease in nerve fibres in cerebral white matter in progressive subcortical encephalopathy of Binswanger type: an electron microscopy study. J Neurol 1989, 7:382-387

[50] 50. Yvonneau M, Vital C, Lafforgue J, Kinsala MS. L'encephalopathie sous corticale chronique de Binswanger: etude anatomo-clinique d'une observation. Bordeaux Med 1969, 5:1135-1141.

[51] 51. Zimmermann RD, Fleming CA, Lee BCP, Saint-Louis LA, Deck MDF. Periventricular hyperintensities as seen by magnetic resonance: prevalence and significance. AJNR 1986, 7:13-20.

[52] 52. Zulch KJ Conceptions nouvelles concernant la pathogénie de 1'ischemie cérébrale. Ann Radiol 1963, 6:7-14.