Binswanger's disease--revisited

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Abstract
During the past 15 years, the proliferation of neuroimaging and the advent of MRI have led to a dramatic change in neurologists' attitudes toward white matter ischemic disease. White matter abnormalities are ubiquitous in the elderly, but many patients with so-called leukoaraiosis do not have vascular dementia. The presence of these white matter abnormalities and their significance has brought Binswanger's disease onto center stage, but the disorder remains very controversial. Debated topics without clear agreement include the definition of the disorder and its appropriate name; the clinical diagnosis of the condition, especially separation from nonvascular causes of white matter changes; and its pathogenesis and treatment. Dementias, including vascular dementias, are an important public health problem that is becoming more common and important as the population ages. Microangiopathic vascular dementia of the Binswanger type is a common cause of vascular dementia and invalidism.