Hypertensive brain diseases: subcortical arteriosclerotic encephalopathy [binswanger's disease]

ABSTRACT

HYPERTENSION is an important risk factor for many forms of cerebrovascular disease, including cerebral infarction, intracerebral hemorrhage and subarachnoid hemorrhage. Although the statistical importance of hypertension as a risk factor for stroke is well known, the only clinical neurological disorder that is caused solely by elevating the blood pressure is hypertensive encephalopathy. Two other neurological conditions are also linked with hypertension Binswanger's disease [BD] and lacunar syndromes. Two hundred and twenty lesions were seen in all stroke patients admitted to King Khalid University Hospital during the period of June 1982 to May 1987. Hypertension was invariably present in all patients with Binswanger's disease and in 75% of patients with lacunar syndromes, as compared to 26% to 37% of patients with arterial infarcts, 54% of patients with cerebral hemorrhage and 30% of patients with subarachnoid hemorrhage. In this series, we will review the pathogenesis, clinical characteristics, and the management of these syndromes Binswanger's disease, lacunar syndromes, and hypertensive encephalopathy