Über Veränderungen an Gehirngefäßen bei Hypertonie

Concerning Cerebral Arteriosclerosis

“…, an increase of adventitial fibers around capillaries, seen by silver impregnation methods, could interfere with exchange of nutriments between blood and tissue; but Gellerstedt (18), finding it in 86 per cent of elderly people with normal mentality, regarded the change as a purely senile manifestation. The “hyalinosis” reported by Anders and Eicke (2) was not studied from a clinical point of view, but it is unlikely that nonoccluding vascular disease of medium‐sized vessels could cause parenchymal changes. Thus, there is no evidence that small‐vessel disease produces dementia.In summary, if the dementia is of slow onset, if the patient is normotensive and there is no suggestion of non‐mental neurologic abnormalities (by history and examination), the diagnosis of senile dementia is entertained.…”

“…As will be discussed later, it is likely that ordinary easily‐recognizable atherosclerosis of the smaller vessels (200–300 μ external diameter) is responsible for the lesions of hypertension, rather than other subintimal changes such as hyalinization or “onion‐skinning” of the cerebral arterioles. Anders and Eicke (2) described “hyalinosis” of the medium and small cerebral arteries. This change was found in all of 34 patients with high blood pressure and in none of the normotensive controls.…”