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Leukoencephalopathy in diffuse hemorrhagic cerebral amyloid angiopathy
Annals of Neurology
|July 1, 1985
Summary
Diffuse hemorrhagic cerebral amyloid angiopathy is linked to white matter loss, particularly in periventricular areas. This leukoencephalopathy may stem from a common hypoperfusion mechanism affecting distal white matter.
Area of Science:
- Neuropathology
- Neuroimaging
- Vascular Neurology
Background:
- Cerebral amyloid angiopathy (CAA) is a significant cause of spontaneous lobar hemorrhage.
- Diffuse white matter changes are increasingly recognized in neurological disorders.
- Understanding the neuropathological correlates of CAA is crucial for diagnosis and treatment.
Purpose of the Study:
- To investigate the white matter changes in patients with diffuse hemorrhagic cerebral amyloid angiopathy.
- To compare postmortem findings with antemortem neuroimaging.
- To explore potential underlying mechanisms for observed leukoencephalopathy.
Main Methods:
- Postmortem examination of 12 patients with diffuse hemorrhagic cerebral amyloid angiopathy.
- Histopathological analysis of brain tissue, focusing on white matter lesions.
- Review of computed tomographic (CT) scans from three patients.
Main Results:
- Eight patients exhibited diffuse bilateral myelin loss in hemispheric white matter, sparing specific tracts.
- Microscopic findings included edema, spongiosis, swollen oligodendroglia, and vascular changes.
- CT scans revealed bilateral hypodensities in the hemispheric white matter.
Conclusions:
- White matter changes in diffuse hemorrhagic cerebral amyloid angiopathy resemble those in Binswanger's subcortical encephalopathy.
- Hypoperfusion of distal white matter is proposed as a common pathogenic mechanism.
- These findings highlight a potential link between CAA and leukoencephalopathy.