Clinical significance of non-dippers among patients with Binswanger's encephalopathy.

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  • Ｂｉｎｓｗａｎｇｅｒ脳症におけるｎｏｎ‐ｄｉｐｐｅｒ型血圧日内変動の臨床的意義

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Abstract

We studied disorders involving nocturnal blood pressure decrease in 33 patients with Binswanger's encephalopathy, evaluating the significance of non-dippers in this disease. When blood pressure was monitored over a 24-hour period (at 30-min intervals). non-dippers (mean night-time blood pressure greater than or equal to mean daytime blood pressure) were found to amount to 16 cases (48.5%). This rate was higher than that in patients with lacunar infarction (18.4%). Cases of non-dippers demonstrated more severe deficits in the vegetable-naming test, Kana pick-out test, and walking ability. MR imaging of non-dippers was characterized by marked periventricular hyperintensity and multiple small highintensity areas in the subcortical and brainstem regions. These findings were not related to intracranial large vessel stenosis on MR angiography and carotid plaque on B-mode ultrasonography. The presence of non-dippers among patients with Binswanger's encephalopathy would imply progress of the disease, associating with small vessel disease in the white matter and other parts of the brain.

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