Binswanger's disease is one of the neurologic syndromes associated with hypertension. It is uncommon, but obviously devastating. The histologic findings are diffuse, irregular loss of axons and myelin accompanied by widespread gliosis. Small infarcts may be seen in the frontal lobes. The pathologic mechanism may be damage caused by severe arteriolosclerosis.
A patient with long term severe hypertension develops progressive dementia. CT scan of the head demonstrates a diffuse loss of deep hemispheric white matter.