Neuropathologic findings in multi-infarct dementia associated with anticardiolipin antibody. Evidence for endothelial injury as the primary event.
OBJECTIVE
There are few reports describing histopathologic changes associated with the antiphospholipid antibody syndrome. We describe a patient with multi-infarct dementia and antiphospholipid antibody syndrome, in whom a brain biopsy was performed.


METHODS
Biopsy material from the left frontal cortex, including meninges, cortex, and underlying subcortical white matter, was investigated. Microscopic examination and special staining were performed.


RESULTS
Microscopic examination showed lumenal occlusion by thrombi, and marked endothelial hyperplasia of small meningeal and cortical arterioles.


CONCLUSIONS
These findings suggest that the pathogenesis of this cerebral vasculopathy is noninflammatory and is associated with reactive endothelial hyperplasia and thrombosis of small arterioles.
Westerman
E M
EM
Department of Pathology, University of Wisconsin, Clinical Science Center, Madison.
Miles
J M
JM
Backonja
M
M
Sundstrom
W R
WR
D017153:Antibodies, Anticardiolipin / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000276:immunology / Q000473:pathology; D001160:Arterioles / Q000473:pathology; D001706:Biopsy; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D015161:Dementia, Multi-Infarct / Q000209:etiology / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000209:etiology / Q000473:pathology
D017153:Antibodies, Anticardiolipin