Cerebral amyloid angiopathy,leukoencephalopathy and dementia of acute onset. Clinicopathological study of a new case

Cerebral amyloid angiopathy (CAA) is a well-established cause of brain hemorrhage in the elderly. The association of CAA with other structural brain lesions is less well known. We report a 69 year old diabetic woman with dementia of acute onset Cranial CT and MRI showed diffuse leukoencephalopathy with predominant right parieto-occipital distribution. Pathological study demonstrated severe CAA. We review the association of CAA with dementia and leukoencephalopathy.     

Common Impact of Chronic Kidney Disease and Brain Microhemorrhages on Cerebral Aβ Pathology in SHRSP

While chronic kidney disease seems to be an independent risk factor for cognitive decline, its impact on cerebral amyloid‐β (Aβ) depositions, one hallmark of Alzheimer's Disease (AD) pathology, has not been investigated. Utilizing 80 male nontransgenic spontaneously hypertensive stroke prone rats (SHRSP) at various ages (12 to 44 weeks), tubulointerstitial renal damage, prevalence of cerebral microhemorrhages and Aβ accumulations were quantified. Using age‐adjusted general linear models we investigated the main and interaction effects of renal damage and cerebral microhemorrhages on cerebral Aβ load. In addition, using post mortem human brain tissue of 16 stroke patients we examined the co‐localization of perivascular Aβ deposits and small vessel wall damage. Statistical models revealed an age‐independent main effect of tubulointerstitial kidney damage on brain Aβ accumulations, which was reinforced by the consecutive presence of cerebral microhemorrhages. Moreover, cerebral microhemorrhages independently predicted brain Aβ burden in SHRSP. In up to 69% of all human cases perivascular Aβ deposits were detected in the direct vicinity of small vessel wall damage. Our results support the associations between vascular pathology and Aβ deposition, and demonstrate a relationship between chronic kidney disease and cerebral Aβ pathology. Hence, our data suggest that prevention of chronic renal damage may reduce cerebral Aβ pathology.     

Association of Kidney Function Measures With Signs of Neurodegeneration and Small Vessel Disease on Brain Magnetic Resonance Imaging: The Atherosclerosis Risk in Communities (ARIC) Study

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