Biomedical subjects
Publications and source records attributed to E J Faccio.
We review the evolution of the concept of Binswanger's disease from his original description in 1894 to our days. We emphasize the conceptual impact caused by CAT scan. Finally, we propose a diagnostic triad based on clinical, neuropathological and radiological trends. We believe Binswanger's disease has a clear identity despite the lack of solid diagnostic criteria.
The case of a patient with paralysis of the lateral gaze to the left, paresis of both eyes when he tried to look upwards and a disfunction of the cerebellum to the left, is reported. During the evolution the paresia of both eyes when the patient looked upwards and the disfunction of the cerebellum disappeared, but the paralysis of the lateral gaze to the left, remained. Later on the patient went a little confuse, did not understand what other persons spoke to him, and speak badly. The necropsy showed one old infarct in the medial longitudinal fasciculus in the left, the same type of lesion in the ventral part of the upper pons which was also to the left and demyelinization of the motor lemniscus of the same side. It was also seen a more recent infarct in the transverse gyrus of the left cerebral hemisphere and also the white matter below it. The study of the medial longitudinal fasciculus by means of the secondary degeneration showed that it was crossed above the 6 degrees nuclei, but was straight to the contrary of what is said about it. The authors also observe that the cells of the interstitial nucleus of Cajal were in chromatolysis. These findings justify the syndrome and the absence of the internuclear anterior ophthalmoplegia to the right.
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