Cerebrovascular pathology presenting as corticobasal syndrome: An autopsy case series of 'vascular CBS'
| Autor: | Shanu F. Roemer, Koji Kasanuki, Dennis W. Dickson, Shunsuke Koga |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
inorganic chemicals 0301 basic medicine congenital hereditary and neonatal diseases and abnormalities Pathology medicine.medical_specialty Autopsy Tissue Banks Neuropathology Apraxia Article White matter 03 medical and health sciences 0302 clinical medicine Basal Ganglia Diseases Humans Medicine Corticobasal degeneration Aged Aged 80 and over business.industry organic chemicals Antemortem Diagnosis Brain nutritional and metabolic diseases Neurodegenerative Diseases medicine.disease Cerebrovascular Disorders 030104 developmental biology medicine.anatomical_structure Neurology Frontal lobe Corticospinal tract Female Neurology (clinical) Geriatrics and Gerontology business 030217 neurology & neurosurgery |
| Zdroj: | Parkinsonism Relat Disord |
| ISSN: | 1353-8020 |
| DOI: | 10.1016/j.parkreldis.2019.09.001 |
| Popis: | Background The corticobasal syndrome (CBS) is heterogeneous in terms of postmortem neuropathology. While it has been previously studied with antemortem neuroimaging, clinicopathologic features of corticobasal syndrome associated with cerebrovascular pathology (vascular CBS) have yet to be reported. Methods To identify vascular CBS, we searched the database of the CurePSP Brain Bank for patients with a clinical diagnosis of CBS who failed to meet neuropathologic criteria for corticobasal degeneration (CBD) or other neurodegenerative disease processes, but who had significant cerebrovascular pathology. Hemibrains were assessed macroscopically and processed for histological assessment. Medical records were reviewed to characterize clinical features of vascular CBS. Results Of 217 patients with an antemortem diagnosis of CBS, we identified three patients with vascular CBS. Multiple infarcts in the watershed regions (frontal lobe and motor cortex), periventricular white matter, thalamus, and basal ganglia were observed in two patients. One patient had no cortical infarcts, but had multiple white matter infarcts and corticospinal tract degeneration. All were clinically thought to have CBS based on progressive asymmetric motor symptoms, including rigidity and apraxia, as well as cognitive impairment. Antemortem imaging studies showed findings of chronic cerebrovascular disease, with infarcts or white matter pathology. Conclusions This autopsy study of vascular CBS shows that, while rare, cerebrovascular pathology involving the frontal lobe, white matter tracts, basal ganglia, thalamus, and corticospinal tract can underlie clinical features suggestive of CBS. When neuroimaging suggests an alternative explanation, including chronic infarcts in critical regions, caution is merited in considering CBD as the underlying pathology. |
| Databáze: | OpenAIRE |
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