The identity of lacunar dementia and Binswanger disease Academic Article Article uri icon


MeSH Major

  • Alzheimer Disease
  • Cerebral Angiography
  • Mental Disorders


  • It is postulated here that the dementia occurring in patients with lacunar strokes is due to an ischemic leukoencephalopathy. Severity of the dementia correlates, not with the volume of brain tissue lost from large-artery infarctions, but rather, with the extent of cortex disconnection resulting from demyelination. The term Lacunar Dementia is proposed, instead of the poorly known eponym "Binswanger disease" or the cumbersome descriptive name "subcortical arteriosclerotic encephalopathy." Clinically, Lacunar Dementia presents with gait difficulties, urinary incontinence, parkinsonian features, pseudobulbar palsy, emotional incontinence and dementia. High-resolution CT scan shows decrease density of frontal and periventricular white matter, without contrast enhancement; ventricular dilation, and lacunar infarcts. Small-artery disease lipohyalinosis is the cause of the lacunes and the leukoencephalopathy. Since the advent of the high-resolution CT scan, the frequency of lacunar dementia seems to be increasing, in contrast with the number of cases of multi-infarct dementia.

publication date

  • January 1985



  • Academic Article


Digital Object Identifier (DOI)

  • 10.1016/0306-9877(85)90059-3

PubMed ID

  • 4010577

Additional Document Info

start page

  • 389

end page

  • 91


  • 16


  • 4