Neuropathologic correlates of leuko-araiosis
I. Janota, T. R. Mirsen, V. C. Hachinski, D. H. Lee and H. Merskey
Department of Neuropathology, Institute of Psychiatry, London, England.
We describe the pathologic findings in 17 persons with dementia, 12 of whom
exhibited leuko-araiosis on computed tomographic scan. The presence of
white matter pallor was confirmed on autopsy in 11 of these 12 cases, 9
with Alzheimer's disease and 2 with multi-infarct dementia. Two further
patients, 1 with Alzheimer's disease and 1 with multi-infarct dementia,
proved to have white matter changes on pathologic examination. White matter
pallor coexisted with cerebral amyloid angiopathy in the brains of the
patients with Alzheimer's disease. The presence of severe white matter
pallor in patients with Alzheimer's disease correlated with early death,
while the presence of cortical scars was associated with prolonged
survival. Because early death in patients with Alzheimer's disease has been
linked with severe pathologic and chemical changes, the presence of white
matter pallor may be further evidence of a particularly severe process in
patients with early onset of Alzheimer's disease.
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