q3 - ebnalfady

[ArchivalUser]

A patient with long term severe hypertension develops progressive dementia. CT scan of the head
demonstrates a diffuse loss of deep hemispheric white matter. Which of the following terms best
describes the pathological process that is occurring?

A. Anemic infarcts

B. Hemorrhagic infarcts

C. Hypertensive encephalopathy

D. Lacunae

E. Subcortical leukoencephalopathy

[ArchivalUser]

dd?

[ArchivalUser]

try before posting the answer

[ArchivalUser]

E.may be due to diffuse loss of white matter.

[ArchivalUser]

Ans is EEEEEEEEEEEEEEEEEEEEE
Have a nice day.....................................................

[ArchivalUser]

U TOO MASHA



Explanation:

The correct answer is E. This patient has subcortical leukoencephalopathy (Binswanger's
disease), which 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. None of the
other choices would produce diffuse subcortical white matter involvement.

Anemic infarcts (choice A) can be seen in hypertensive patients as a consequence of
atherosclerotic thromboembolic events.

Hemorrhagic infarcts (choice B) can also be seen in hypertensive patients as a consequence of
atherosclerotic thromboembolic events followed by reperfusion. They tend to occur in gray
matter or at the gray-white junction.

Hypertensive encephalopathy (choice C) is an acute generalized dysfunction of the brain that
can occur in malignant hypertension or other very severe hypertensive processes. The primary
pathology is seen in cerebral vessels, although cerebral edema may be present.

Lacunae (choice D) are small necrotic foci in deep gray matter (especially basal ganglia and
thalamus) seen in some hypertensive patients.