[Arterial hypertension and pathology of cerebral white matter]

Abstract

White matter of the brain in 25 autopsy cases with the stroke and chronic cerebro-vascular pathology produced by arterial hypertension (AH) was studied morphologically. Focal and diffuse changes of the white matter were found against the background of the hypertonic angiopathy. These changes were represented by lacunar infarcts, foci of incomplete necrosis, perivascular encephalolysis, more seldom by small haemorrhages in combination with edema, cribriform lesions and widespread spongiosis of the white matter. Alterations of the cortex-medullary arteries, microcirculatory bed, disturbances of the dynamics of liquor and permeability of blood-brain barrier play the most important role in the white matter damage. The authors distinguish 3 forms of this damage. The complex of these alterations is regarded as a morphological substrate of a vascular dementia associated with AH.