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Reply from the Author: All patients with Binswanger's disease have some enlargement of the ventricular system. Some of the ventricular dilatation is due to the loss of white matter-an ex vacuo phenomenon. The physical composition of the remaining white matter is also abnormal in patients with severe leukoen-cephalopathy. The white matter becomes rubbery and may not provide normal mechanical support to the periventricular regions, allowing further ventricular dilatation.
I agree with Grotta and Morgenstern that NPH and Binswanger's disease may be difficult to separate both …
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