White matter changes in old age dementia. 1991

M Alexianu, and B Tudorache, and E Constantinescu
Institute of Neurology and Psychiatry, Bucharest, Romania.

This is the clinico-morphological study of 70 patients above age 60 with the clinical diagnosis of dementia made on clinico-psychometric criteria for the assessment of the deterioration-dementia state, and in some cases, using the Hachinski scale. For morphological macro- and microscopic examinations of the brain, the classic neuropathologic techniques were used. Although no case selection was carried out, the number of cases was uniformly distributed between the ages of 60-74 years. The sample was also relatively uniform with regard to the patients' sex. Morphologically, our patient group included cases with vascular dementia (VD-33%), mixed dementia (MD-14.3%), Alzheimer-type dementia (ATD-20%), isolated SAE (17%), other cases (15.7%). Myelinic pallors and rarefactions were present in 41.4% of all cases of which: as a single lesion in 41.4%, associated with VD in 34.5%, with MD in 17.2% and with ATD in 6.9%. Microscopic background of myelinic changes was represented by acute (perivascular and pericellular edema) and chronic (myelinic destruction, gliosis, perivascular hematic pigment) edematous lesions. In 10.3% of cases with myelinic changes, marked dilation and blood stasis in large periventricular and/or subcortical vessels with subsequent cerebral edema, generally overlapping critical zones of venous circulation could be observed. The size and severity of the myelinic lesions were not clearly correlated to the intra- and extraparenchymatous vascular changes. However, the myelinic involvement was more in cases with lesions, mainly atherosclerotic, of the vessel walls. The possible intervention of the venous factor in the development of subcortical arteriosclerotic encephalopathy (SAE) is discussed among other etiopathogenic factors.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009186 Myelin Sheath The lipid-rich sheath surrounding AXONS in both the CENTRAL NERVOUS SYSTEMS and PERIPHERAL NERVOUS SYSTEM. The myelin sheath is an electrical insulator and allows faster and more energetically efficient conduction of impulses. The sheath is formed by the cell membranes of glial cells (SCHWANN CELLS in the peripheral and OLIGODENDROGLIA in the central nervous system). Deterioration of the sheath in DEMYELINATING DISEASES is a serious clinical problem. Myelin,Myelin Sheaths,Sheath, Myelin,Sheaths, Myelin
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D003704 Dementia An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. Senile Paranoid Dementia,Amentia,Familial Dementia,Amentias,Dementia, Familial,Dementias,Dementias, Familial,Dementias, Senile Paranoid,Familial Dementias,Paranoid Dementia, Senile,Paranoid Dementias, Senile,Senile Paranoid Dementias
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D015140 Dementia, Vascular An imprecise term referring to dementia associated with CEREBROVASCULAR DISORDERS, including CEREBRAL INFARCTION (single or multiple), and conditions associated with chronic BRAIN ISCHEMIA. Diffuse, cortical, and subcortical subtypes have been described. (From Gerontol Geriatr 1998 Feb;31(1):36-44) Arteriosclerotic Dementia,Binswanger Disease,Encephalopathy, Binswanger,Leukoencephalopathy, Subcortical,Subcortical Arteriosclerotic Encephalopathy,Vascular Dementia,Acute Onset Vascular Dementia,Arteriosclerotic Encephalopathy, Subcortical,Binswanger Encephalopathy,Binswanger's Disease,Chronic Progressive Subcortical Encephalopathy,Encephalopathy, Binswanger's,Encephalopathy, Chronic Progressive Subcortical,Encephalopathy, Subcortical Arteriosclerotic,Encephalopathy, Subcortical, Chronic Progressive,Subcortical Encephalopathy, Chronic Progressive,Subcortical Leukoencephalopathy,Subcortical Vascular Dementia,Vascular Dementia, Acute Onset,Arteriosclerotic Dementias,Arteriosclerotic Encephalopathies, Subcortical,Binswanger's Encephalopathy,Binswangers Disease,Dementia, Arteriosclerotic,Dementia, Subcortical Vascular,Dementias, Arteriosclerotic,Dementias, Subcortical Vascular,Dementias, Vascular,Disease, Binswanger,Disease, Binswanger's,Encephalopathies, Subcortical Arteriosclerotic,Encephalopathy, Binswangers,Leukoencephalopathies, Subcortical,Subcortical Arteriosclerotic Encephalopathies,Subcortical Leukoencephalopathies,Subcortical Vascular Dementias,Vascular Dementia, Subcortical,Vascular Dementias,Vascular Dementias, Subcortical

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