Stroke, Vol 24, 122-125, Copyright © 1993 by American Heart Association
M Baudrimont, F Dubas, A Joutel, E Tournier-Lasserve and MG Bousser
BACKGROUND AND PURPOSE: We recently described an autosomal dominant
syndrome characterized mainly by recurrent strokes and neuroimaging
evidence of leukoencephalopathy. We now report the pathological findings in
one of the affected subjects. CASE DESCRIPTION: A 40-year- old woman
experienced her first grand mal seizure in 1971. From 1983 on she suffered
recurrent strokes, seizures, and psychiatric disturbances with depressions,
manic episodes, and dementia. In 1988, after her fourth stroke, she became
tetraplegic with a severe pseudobulbar palsy, and she died in 1990.
Pathological examination disclosed a recent capsulolenticular hematoma,
multiple small deep infarcts, a diffuse myelin loss and pallor of the
hemispheric white matter, and a widespread vasculopathy of the small
arteries penetrating the white matter. The arterial wall was markedly
thickened with an extensive nonamyloid eosinophilic deposit in the media
and reduplication of the internal elastic lamella. CONCLUSIONS: The
underlying lesion of this hereditary disorder is located in the small
arteries and is of unknown etiology. It differs from arteriosclerotic and
amyloid angiopathies but is similar to that described in some cases of
hereditary multi-infarct dementia.
ARTICLES
Autosomal dominant leukoencephalopathy and subcortical ischemic stroke. A clinicopathological study
Service de Neurologie A, INSERM U 298, Centre Hospitalier Universitaire, Angers, France.
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