title: An autopsy case of coexisting portal systemic encephalopathy and senile dementia of the Alzheimer type.
abstract: An autopsy case of portal systemic encephalopathy and senile dementia of the Alzheimer type coexisting in a 77-year-old man is described. The patient had suffered recurrent episodes of delirium after a subtotal gastrectomy for gastric carcinoma. He died of DIC 45 months after the gastrectomy. A pathological examination revealed a vascular plexus around the liver which might have served as collateral circulation. Neuropathologically, spongy necrosis and Alzheimer type II changes of astrocytes were found in the basal ganglia and fronto-occipital cortices. In the same anatomical regions, only immunohistological staining using antibody against amyloid beta-protein and the periodic-acid methenamine silver method revealed abundant neuriticplaques, cerebral amyloid angiopathy and diffuse plaques. We discussed the clinicopathological findings in this case.
authors.affiliation: Department of Neuropsychiatry, Yamanashi Medical College, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Asada
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
authors.forename: M
authors.initials: M
authors.lastname: Hirano
authors.forename: M
authors.initials: M
authors.lastname: Atobe
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology*; D001253:Astrocytes / Q000473:pathology; D001921:Brain / Q000473:pathology; D005743:Gastrectomy; D006501:Hepatic Encephalopathy / Q000473:pathology*; D006801:Humans; D006975:Hypertension, Portal / Q000473:pathology*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D009336:Necrosis; D016501:Neurites / Q000473:pathology; D011183:Postoperative Complications / Q000473:pathology*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*