Diffuse White Matter Involvement Seen in Patients in Longstanding Bedridden State from Cerebrovascular Dementia

We report here two autopsied cases of patients who had been in a longstanding bedridden state from cerebrovascular dementia. They showed a clinical history of persistent hypertension, a history of acute strokes, a lengthy clinical course with long plateau periods a gradual accumulation of focal neurological symptoms signs, including dementia prominent motor disturbances pseudobulbar palsy. They had been in a bedridden state for the last several years had to be fed. The pathology seemed to predominently affect the perforating vessels to the subcortical gray white matter. Demyelination, loss of axons, patehygliosis infiltration by macrophages were noted in the involved regions. The long penetrating vessels of the white matter showed advanced arteriosclerotic changes. There was a relative sparing of the cortex. The low attenuation of the white matter with moderate to severe atrophy, an infarction might well be significant features on a CT‐scan of these conditions. One of the possible mechanisms on the pathogenesis of chronic vascular disease includes diffuse ischemia related to hypertensive vasculopathy.