title: Sneddon's syndrome: a cause of cognitive decline in young adults.
abstract: OBJECTIVE
  To review the clinical, psychometric, laboratory, and radiologic findings of 6 patients with Sneddon's syndrome (SS) who presented with cognitive dysfunction rather than stroke.
  
  
  METHODS
  Case series. All patients fulfilled were diagnosed as SS based on the co-occurrence of livedo racemosa and neurologic disease. Patients presenting with clinical stroke were excluded.
  
  
  RESULTS
  Patients presented with cognitive complaints at an early age and all noted skin lesions from 6 months to 10 years before onset of cognitive symptoms. Associated systemic disorders included hypertension and seizures. Laboratory evidence of a hypercoagulable condition was identified in 4 of 6 cases. Brain MRI scans demonstrated atrophy, especially in parieto-occipital regions and cerebral blood flow on brain SPECT scan was reduced in a similar distribution.
  
  
  CONCLUSIONS
  Patients with SS can develop dementia without antecedent clinical stroke. While the specific pathogenic mechanism of dementia in SS remains speculative, the disease predominantly injures brain tissue in vascular "watershed" territories.
authors.affiliation: Neurology Service, Albuquerque Veterans Affairs Medical Center, New Mexico 87108, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Adair
authors.forename: K B
authors.initials: KB
authors.lastname: Digre
authors.forename: R M
authors.initials: RM
authors.lastname: Swanda
authors.forename: M F
authors.initials: MF
authors.lastname: Hartshorne
authors.forename: R R
authors.initials: RR
authors.lastname: Lee
authors.forename: T M
authors.initials: TM
authors.lastname: Constantino
authors.forename: J E
authors.initials: JE
authors.lastname: Knoefel
mesh_terms: D000328:Adult; D001284:Atrophy / Q000150:complications / Q000473:pathology; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010859:Pigmentation Disorders / Q000175:diagnosis / Q000453:epidemiology; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000175:diagnosis / Q000453:epidemiology; D018860:Sneddon Syndrome / Q000175:diagnosis*; D015899:Tomography, Emission-Computed, Single-Photon