Alzheimer's disease associated with arteriosclerotic cerebrovascular lesions
Mitsuyama, Y.
Seishin Shinkeigaku Zasshi 84(3): 184-197
1982
ISSN/ISBN: 0033-2658 PMID: 7111515 Document Number: 189226
Nine autopsied cases of Alzheimer's disease were reported. Four of them were associated with arteriosclerotic cerebrovascular lesions. Onset was between 36 and 60, and the age at death was between 41 and 65 yr of age. Their clinical courses were similar and steadily progressive without remissions. Their symptoms were characterized by mnestic disturbances, spatial disorientation, aphasia and developed to complete dementia. Three of four cases associated with arteriosclerotic cerebrovascular lesions had a longstanding history of hypertension and arteriosclerotic retinopathy. In addition to the widespread presence of senility related changes, hyalinosis of small arteries, atherosclerosis and small infarcts were found throughout the CNS in cases with arteriosclerotic cerebrovascular lesions. Cases associated with cerebrovascular lesions seem to show a more rapid clinical course, high prevalence of nocturnal restlessness, fluctuation in their symptoms and urinary incontinence in their initial stages as compared with classical Alzheimer's disease. Although arteriosclerotic cerebrovascular lesions were an incidental finding and had little influence on the entire clinical picture of Alzheimer's disease, more consideration of the vascular lesions in Alzheimer's disease is recommended because the coexistence of vascular lesions in this disease seems frequent. In this presentation, the importance of the history and presence of hypertension was stressed for the correct diagnosis of Alzheimer's disease associated with arteriosclerotic cerebrovascular lesions.