ABSTRACT
Binswanger's disease (BD) is an illness of hypertensive elderly patients characterised clinically by disorders of memory, mood and cognition; focal motor signs; and less often, a pseudobulbar syndrome with deterioration of gait and sphincter control. The illness is usually slowly progressive. The important pathological features of BD are widespread degeneration in the deep white matter with diffuse, patchy axonal and myelin loss, and gliosis. The more diffuse lesions in the centrum semiovale have been related to myelin rarefaction that spares the U-fibers. The MRI appearance of BD is multiple confluent white matter lesions of various sizes, many of which are quite small and concentrated around the basal ganglia and periventricular areas. We report an autopsy case of Binswanger's disease associated with Alzheimer's pathology.