The Incidence of Cerebrovascular Lesions in Vascular Dementia Due to Arteriosclerosis and Due to Cerebral Amyloid Angiopathy: A Post-Mortem Neuropathological Study With 7.0-Tesla Magnetic Resonance Imaging

Introduction and Purpose: Arteriosclerotic small vessel disease (Art) is the main cause of vascular dementia (VaD).Cerebral amyloid angiopathy (CAA) can also lead to VaD.However it is not known whether the responsible cerebrovascular lesions and their severity are the same in VaD-Art and VaD-CAA.The present post-mortem study with additional 7-tesla magnetic resonance imaging (MRI) compares the incidence and the distribution of these lesions in both VaD disease types.Material and Methods: 32 brains with pure VaD due to Art and due to CAA, and 31 with VaD-Art and VaD-CAA mixed with additional neurodegenerative pathology were compared separately.MRi was mainly used to compare the regional severity of the white matter changes (WMCs) and the incidence of cortical micro-infarcts (CoMIs) and cortical micro-bleeds (CoMBs) on serial cerebral hemispheric sections between both groups of VaD.Results: VaD-CAA was characterized by the more frequent occurrence of CoMIs and lobar haematomas while in VaD-Art lacunar infarcts predominated in the pure as well in the mixed forms.On MRI WMCs were more severe in the central section and to a minor degree in the mixed VaD-CAA, as well as CoMiBs in the frontal section.CoMIs were equally increased in the different sections.Conclusions: There are significant differences in the severity and the topographic distributions of cerebrovascular lesions between VaD-Art and VaD-CAA brains.However, the increased WMCs and CoMiBs in the mixed form of VaD-CAA could possibly be related to the additional neurodegenerative changes.Cerebrovascular lesions are a frequent finding in the elderly population.However, the impact of these lesions on cognitive performance, the prevalence of vascular dementia (VaD), and the pathophysiology behind the characteristics In vivo imaging findings are subject to controversy [1].There are no generally accepted