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BMC Medicine
Published in: BMC Medicine 1/2016

Open Access 01-12-2016 | Opinion

Post-mortem assessment in vascular dementia: advances and aspirations

Authors: Kirsty E. McAleese, Irina Alafuzoff, Andreas Charidimou, Jacques De Reuck, Lea T. Grinberg, Atticus H. Hainsworth, Tibor Hortobagyi, Paul Ince, Kurt Jellinger, Jing Gao, Raj N. Kalaria, Gabor G. Kovacs, Enikö Kövari, Seth Love, Mara Popovic, Olivia Skrobot, Ricardo Taipa, Dietmar R. Thal, David Werring, Stephen B. Wharton, Johannes Attems

Published in: BMC Medicine | Issue 1/2016

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Abstract

Background

Cerebrovascular lesions are a frequent finding in the elderly population. However, the impact of these lesions on cognitive performance, the prevalence of vascular dementia, and the pathophysiology behind characteristic in vivo imaging findings are subject to controversy. Moreover, there are no standardised criteria for the neuropathological assessment of cerebrovascular disease or its related lesions in human post-mortem brains, and conventional histological techniques may indeed be insufficient to fully reflect the consequences of cerebrovascular disease.

Discussion

Here, we review and discuss both the neuropathological and in vivo imaging characteristics of cerebrovascular disease, prevalence rates of vascular dementia, and clinico-pathological correlations. We also discuss the frequent comorbidity of cerebrovascular pathology and Alzheimer’s disease pathology, as well as the difficult and controversial issue of clinically differentiating between Alzheimer’s disease, vascular dementia and mixed Alzheimer’s disease/vascular dementia. Finally, we consider additional novel approaches to complement and enhance current post-mortem assessment of cerebral human tissue.

Conclusion

Elucidation of the pathophysiology of cerebrovascular disease, clarification of characteristic findings of in vivo imaging and knowledge about the impact of combined pathologies are needed to improve the diagnostic accuracy of clinical diagnoses.
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Metadata
Title
Post-mortem assessment in vascular dementia: advances and aspirations
Authors
Kirsty E. McAleese
Irina Alafuzoff
Andreas Charidimou
Jacques De Reuck
Lea T. Grinberg
Atticus H. Hainsworth
Tibor Hortobagyi
Paul Ince
Kurt Jellinger
Jing Gao
Raj N. Kalaria
Gabor G. Kovacs
Enikö Kövari
Seth Love
Mara Popovic
Olivia Skrobot
Ricardo Taipa
Dietmar R. Thal
David Werring
Stephen B. Wharton
Johannes Attems
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2016
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-016-0676-5

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