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Washington University Experience | MYELIN (NON-IMMUNE MEDIATED) | Binswangers | 2A0 Case 2 History
Case 2 History ---- This patient was a 66-year-old woman with a history of presumed Alzheimer’s dementia, coronary artery disease, upper gastrointestinal bleed, hypertension, cerebrovascular accident, rheumatoid arthritis and a recent admission for a ST elevation myocardial infarction that was medically managed in the CCU. The patient was readmitted to the Medical Intensive Care Unit with polymicrobial septic shock and respiratory failure. The patient presented again within a week of discharge after an unwitnessed code at her nursing home. On presentation to the BJH ED, the patient remained pulseless with an unreportable blood pressure, was partially resuscitated, and then expired. Autopsy The weight of the unfixed brain is 1010 g. No neurofibrillary tangles, neuritic plaques, Pick bodies, ballooned cells, Lewy bodies, amyloid angiopathy, or "glial plaques" were seen in H&E, Bielschowsky, PHF1, beta-amyloid, and alpha-synuclein stained material. The extensive white matter involvement and infarcts of varying ages would be consistent with clinical diagnoses of "Binswanger's Disease" and/or "Multi-infarct Dementia".
