[Diffuse bilateral periventricular hyperintensity of unknown origin on MRI spin-echo sequence. Cognitive function and regional cerebral blood flow].
Cognitive function and regional cerebral blood flow (rCBF) were studied in 26 patients (mean age 77.9) who showed bilaterally an ill-defined diffuse periventricular hyperintensity (PVH) on the magnetic resonance imaging (MRI) spin-echo sequence. Diffuse PVH was classified into two groups according to severity, group A (more severe) and group B (less severe); their cognitive impairment was classified into three stages, stage 1 (mildly impaired) through stage 3 (severely impaired). rCBF was assessed by single photon emission computed tomography (SPECT). The result showed that 6 of 7 MRI-group A patients were stage 3, but the stages of 19 group B patients varied. Five of 7 MRI-group A patients showed severe hypoperfusion, but rCBF of group B patients also varied. Nineteen patients had a hypertensive history, but only 10 patients complained of cerebrovascular incidents before admission. All 3 younger patients (one in his fifties and two in their sixties), however, showed hypertension, stepwise neurological deterioration as in Binswanger's disease. These results suggest that there might be various pathogenesis of diffuse bilateral PVH in the elderly and they are different from that of the classical "Binswanger's disease".
Lee
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Second Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001921:Brain / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003072:Cognition Disorders / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged