Binswanger’s disease: symptoms, causes and treatment of this dementia.

This type of vascular dementia is related to arteriosclerosis.

Dementias involve loss of brain function, and are due to multiple causes and diseases. They affect memory, thinking, language, judgment and behavior, and appear mostly after the age of 60.

In this article we will discuss Binswanger's disease, a neurological disorder that causes vascular dementia.. This type of dementia involves symptoms such as manic episodes and loss of inhibition, and constitutes 1-5% of all dementias.

Binswanger's disease: characteristics

Binswanger's disease is a disease that causes vascular-type dementia, and is characterized by atrophy of the characterized by atrophy of the cerebral white matter.. It arises as a consequence of a vascular deficiency due to severe arteriosclerosis of the vessels supplying the deep white mass. We will see later what arteriosclerosis is.

This type of dementia involves the presence of infarcts of two types: lacunar and cortical. In terms of prevalence, dementia due to Binswanger's disease accounts for between 1 and 5% of all dementias.

Risk factors.

The main risk factor for Binswanger's disease is high Blood pressure (94% of patients with the disease are hypertensive), coupled with age and the degree of severity of cerebral arteriosclerosis.

In addition, dementia is often also associated with the presence of type 2 diabetes, thrombocytosis, hyperlipidemia, and coronary artery disease..

Symptoms

Patients with dementia due to Binswanger's disease, in most cases, present their first symptoms between 60 and 70 years of age, present their first symptoms between 60 and 70 years of age.. There are no differences between women and men in terms of symptoms or likelihood of developing this disease.

On the other hand, on average, the life expectancy of patients is 5 years longer from the time of diagnosis.

The first three symptoms of Binswanger's disease, which appear in the early stages and in 70% of cases, are as follows.

1. Manic episodes

Manic episodes are delimited and persistent periods during which an abnormally high mood appears. an abnormally elevated, expansive or irritable mood.. These episodes are easy to detect because the person feels especially energetic, impulsive and euphoric, with ideas of grandiosity. It is a psychological state similar to hypomania.

2. Alterations of judgment

The capacity of judgment is the cognition with which thinking worksJudging involves establishing relationships between two or more concepts. In everyday life, we use judgment or logic to understand things and analyze reality with common sense.

Patients with Binswanger's disease dementia have impaired judgment or logic, presenting difficulties in this type of reasoning or thinking.

3. Loss of inhibition

Inhibition or inhibitory control is the ability of the human being to inhibit or control impulsive (or automatic) responses and to (or automatic) responses, and generate responses mediated by attention and reasoning. It is a cognitive ability that contributes to anticipation, planning and goal setting.

In Binswanger's disease this ability is altered, and the patient loses this ability to plan and organize his behavior. Similarly, it begins to develop behavioral patterns characterized by impulsivity.

4. Other symptoms

Subsequently, as the disease progresses, the patient develops abulia (lack of will or energy to do something or to move), as well as orientation problems. The person begins to depend on others in performing activities of daily living (ADLs).

On the other hand, sometimes there may be a loss of short-term or long-term memoryThis is typically seen in several types of dementia. Mental symptoms may also appear in association with other symptoms of neurological origin, such as lack of motor coordination (walking) or the presence of seizures.

Causes

Dementia due to Binswanger's disease is caused by a vascular deficiency. This is due to the existence of severe arteriosclerosis. of the vessels that irrigate the deep white matter.

Arteriosclerosis, on the other hand, is a condition where plaque builds up inside the arteries. plaque builds up inside the arteries.Plaque is a sticky substance composed of fat, cholesterol, calcium and other substances found in the blood. Over time, this plaque hardens and narrows the arteries, limiting the flow of oxygen-rich blood.

Treatment

Once Binswanger's disease dementia has been diagnosed, treatment is essentially symptomatic, treatment is essentially symptomatic. On the other hand, arterial hypertension is treated, until it is established in figures within the normal range (below 140/90 mm/Hg), which allows stabilizing the symptoms.

Some authors suggest reducing hematocrit when it is above 45%; hematocrit is directly related to fibrinogen levels and blood viscosity.

It is important to emphasize that the treatment of Binswanger's disease should focus primarily on preventive treatment and control of high blood pressure. preventive treatment and control of arterial hypertension, as this is the main risk factor associated with the disease.as this is the main risk factor associated with the disease. Thus, preventing and controlling hypertension will help to avoid cerebral arteriosclerosis that gives rise to dementia.

Bibliographic references:

• Caplan L.R. (1995). Binswanger's disease revisited. Neurology, 45; 626-633.
• Libon, D.; Price, C.; Davis Garrett, K.; Giovannetti, T. (2004). From Binswanger's Disease to Leukoaraiosis: What We Have Learned About Subcortical Vascular Dementia. The Clinical Neuropsychologist. 18(1): 83 - 100.
• Rodriguez, L. and Serra, Y. (2002). Clinical-imaging characterization of Binswanger's disease. Rev cubana med 41(3), Havana City. International Center for Neurological Restoration.
• Valencia C. (2002). Comparative analysis of Alzheimer's disease leukoaraiosis, Binswanger's disease and lacunar infarcts. Conventional and spectroscopic MRI study. Autonomous University of Barcelona. Department of Medicine.