The impact of cerebral amyloid angiopathy on the occurrence of cerebrovascular lesions in demented patients with Alzheimer features: a neuropathological study.
OBJECTIVE
The aim of this neuropathological study was to determine the prevalence of the different cerebrovascular lesions to be attributed to cerebral amyloid angiopathy (CAA) and of those associated with the severity of the Alzheimer dementia (AD) itself.


METHODS
The cerebrovascular lesions were compared separately in 40 brains of patients with mild and 50 with severe AD features. In the two groups, the number of lesions were compared between the brains with severe and those with mild of absent CAA.


RESULTS
The age of the patients, the vascular risk factors and antithrombotic treatment were similar in all the compared groups. The brains with mild and severe AD features and with CAA contained more haematomas, cortical micro-infarcts and micro-bleeds, and more severe white matter changes, and cortico-subcortical and white matter mini-bleeds. In the CAA brains with severe AD features, also more cortical territorial infarcts were observed, compared to those with mild AD features.


CONCLUSIONS
The increase in cortical infarcts cannot be attributed to the CAA alone, but also to the severity of the degenerative features, implying additional vascular factors in the pathogenesis of AD.
Université Lille Nord de France, UDSL, EA 1056, Lille, France. dereuck.j@gmail.com
J
J
De Reuck
V
V
Deramecourt
C
C
Cordonnier
D
D
Leys
C A
CA
Maurage
F
F
Pasquier
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D020520:Brain Infarction / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D016657:Cerebral Amyloid Angiopathy / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D002536:Cerebral Arteries / Q000473:pathology* / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D015995:Prevalence; D012720:Severity of Illness Index
D005343:Fibrinolytic Agents