Binzwanger disease, also known as subcortical leukoencephalopathy, is a form of vascular dementia caused by damage to the white matter of the brain. The atrophy of the white matter can occur as a result of a number of conditions, such as chronic hypertension and aging. The disease is characterized by loss of memory and intellectual function, along with changes in mood, which surround what is known as the executive functions of the brain. The disease usually occurs between the ages of 54 and 66, with early symptoms being mental decline or stroke. Otto Binzwanger first described the disease in 1894, and Alois Alzheimer used the term "Binzwanger disease" in 1902. However, Olszewski is credited with much of the modern investigation of the disease, which began in 1962. Symptoms include mental decline, language impairment, transient ischemic attacks, and ataxia, a movement disorder that includes gait abnormalities, slow movements, and postural changes. These symptoms are often accompanied by multiple falls, seizures, fainting, and bladder control. Since Binswanger disease affects the speed of information processing and causes poor concentration, the ability to perform daily tasks such as managing money and preparing meals can become extremely difficult. Binswanger disease is a type of subcortical vascular dementia caused by atrophy of the brain's white matter. However, atrophy of the white matter alone is not sufficient; evidence of subcortical dementia is also necessary. Histological findings include diffuse and patchy loss of axons and myelin with widespread neuroglial damage, tissue death due to infarction or loss of blood supply to the brain, and changes in the neuroplasticity of the arteries. The pathogenesis may lie in damage from severe atherosclerosis. The onset of the disease is usually between the ages of 54 and 66 years and the first symptom is usually mental decline or stroke. The vessels supplying the subcortical white matter branch off from vessels supplying the basal ganglia, the basal capsule, and the thalamus. Chronic hypertension is known to cause changes in the smooth wall tone of blood vessels as well as changes in vessel diameter. Consequently, arteries can become permeable, leading to a breach of the blood-brain barrier. Binzwanger disease has been shown to target vessels in this subcortical region, excluding the microcirculatory vessels and capillaries, which is why Alzheimer's disease differs from Binzwanger disease. Binzwanger disease has no cure and has been shown to be the most severe form of vascular dementia, but the best way to address vascular risk factors that contribute to poor brain perfusion is to treat the underlying cause, such as chronic hypertension or diabetes. The current Alzheimer's drug donepezil has also been shown to help Binzwanger disease.