Evaluation of cerebral biopsies for the diagnosis of dementia.
To identify those patients most likely to benefit from a cerebral biopsy to diagnose dementia, we reviewed a series of 14 unselected biopsies performed during a 9-year period (1980 through 1989) at Duke University Medical Center, Durham, NC. Pathognomonic features allowed a definitive diagnosis in seven specimens. Nondiagnostic abnormalities but not diagnostic neuropathologic changes were seen in five additional specimens, and two specimens were normal. Creutzfeldt-Jakob disease was the most frequent diagnosis. One patient each was diagnosed as having Alzheimer's disease, diffuse Lewy body disease, adult-onset Niemann-Pick disease, and anaplastic astrocytoma. We conclude that a substantial proportion of patients presenting clinically with atypical dementia are likely to receive a definitive diagnosis from a cerebral biopsy. However, in those with coexisting hemiparesis, chorea, athetosis, or lower motor neuron signs, cerebral biopsies are less likely to be diagnostic.
Hulette
C M
CM
Department of Pathology, Duke University Medical Center, Durham, NC 27710.
Earl
N L
NL
Crain
B J
BJ
D000328:Adult; D000368:Aged; D001706:Biopsy; D001921:Brain / Q000473:pathology*; D003704:Dementia / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged