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Related Experiment Videos

Neuropathologic substrates of ischemic vascular dementia.

H V Vinters1, W G Ellis, C Zarow

  • 1Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California 90095-1732, USA.

Journal of Neuropathology and Experimental Neurology
|November 23, 2000
PubMed
Summary

Ischemic vascular dementia (IVD) involves multiple brain lesions causing cognitive decline. Autopsy findings reveal lacunar infarcts and microinfarcts are common in IVD patients.

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Area of Science:

  • Neurology
  • Pathology
  • Gerontology

Background:

  • Ischemic vascular dementia (IVD) is characterized by progressive cognitive and memory impairment due to multiple ischemic brain lesions.
  • These lesions can exacerbate neuropsychological deficits in Alzheimer disease (AD).
  • Cerebral microvascular disease is a key factor in many dementia cases.

Purpose of the Study:

  • To review neuropathological findings in 20 patients with diagnosed IVD.
  • To correlate vascular pathologies with cognitive impairment.
  • To propose a method for quantifying ischemic burden in dementia.

Main Methods:

  • Autopsy examination of the central nervous system from 20 patients (aged 68-92).
  • Longitudinal investigation including structural, neurochemical, neuroimaging, and neuropsychological assessments.

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  • Analysis of neuropathological abnormalities such as infarcts and vascular changes.
  • Main Results:

    • Lacunar infarcts and microinfarcts were the most common abnormalities, found in over half of the patients.
    • Evidence of hippocampal injury was present in 11/20 patients.
    • Severe atherosclerosis and arterio/arteriolosclerosis correlated with multiple lacunar infarcts.

    Conclusions:

    • IVD is associated with widespread small ischemic lesions throughout the CNS.
    • Quantifying ischemic and parenchymal disease burden may aid in understanding dementia syndromes.
    • Neuropathological features of both familial and sporadic vascular dementia are relevant.