Document Detail


Cerebral amyloid angiopathy with severe secondary vascular pathology: a histopathological study.
MedLine Citation:
PMID:  16179828     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cerebral amyloid angiopathy (CAA) is a common neuropathological finding and is characterized by deposition of fibrillar amyloid in cortical and leptomeningeal vessels. In this study we describe the macroscopic and microscopic neuropathological findings of 5 patients with severe CAA-associated secondary vascular changes, including smooth muscle cell degeneration, hyalinization, 'double-barreling' phenomenon, macrophage infiltration, and aneurysmal dilatation of the vessel wall. In 3 of the 5 patients these vascular changes were associated with multiple small hemorrhages, whereas in 2 patients areas of ischemic necrosis were observed. However, none of these patients suffered from large (lobar) hemorrhagic accidents. Nevertheless, severe CAA, particularly when associated with secondary vascular pathology, may lead to vascular dementia-like ischemic changes. Hence, the distinction between patients with severe CAA and secondary vascular abnormalities from those suffering from vascular dementia can be difficult. We speculate that CAA, particularly when associated with secondary vascular pathology, although not resulting in large hemorrhages, may contribute to cognitive decline. The functional impact of CAA and CAA-related secondary vascular changes on cognitive performance warrants further exploration.
Authors:
Jack van Horssen; Danielle de Jong; Robert M W de Waal; Cathy Maass; Irene Otte-Holler; Berry Kremer; Marcel M Verbeek; Pieter Wesseling
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-09-22
Journal Detail:
Title:  Dementia and geriatric cognitive disorders     Volume:  20     ISSN:  1420-8008     ISO Abbreviation:  Dement Geriatr Cogn Disord     Publication Date:  2005  
Date Detail:
Created Date:  2005-10-12     Completed Date:  2005-12-01     Revised Date:  2008-03-24    
Medline Journal Info:
Nlm Unique ID:  9705200     Medline TA:  Dement Geriatr Cogn Disord     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  321-30     Citation Subset:  IM    
Affiliation:
Department of Pathology, University Medical Center, Nijmegen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Amyloid beta-Protein / metabolism
Amyloid beta-Protein Precursor / genetics
Apolipoproteins E / genetics
Cerebral Amyloid Angiopathy / genetics,  pathology*
Cerebral Arteries / pathology
Cerebrovascular Circulation / physiology*
Female
Humans
Immunohistochemistry
Inflammation / pathology
Male
Neurodegenerative Diseases / pathology
Risk Factors
Chemical
Reg. No./Substance:
0/Amyloid beta-Protein; 0/Amyloid beta-Protein Precursor; 0/Apolipoproteins E

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