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Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 6 LBD - Microscopic Pathology - Cerebral Cortex | 5C Case 5 Denouement
Neuro Final Diagnoses: Alzheimer's disease; Dementia with Lewy bodies; Hemorrhage, right subdural, subarachnoid; Contusions, subacute, right middle frontal and left inferior frontal lobes ---- Neuro Diagnosis Comment: Histological slides of representative neocortical areas show sparse to focally frequent beta-amyloid plaques, but only a few neuritic plaques and neurofibrillary tangles which were not sufficient to meet CERAD or NIA-Reagan Institute criteria. In addition to tau and beta-amyloid pathology, this case also displayed alpha-synuclein-positive inclusions in the form of Lewy bodies and Lewy neurites. In the staging of Lewy body pathology according to Braak et al. (PMID: 12498954), this case is consistent with stage 6 of a six stage scale (range 1-6), meeting the criteria for dementia with Lewy bodies neocortical stage and in the revised criteria, which take account of coexisting Alzheimer's disease, there is a “high” probability that the dementia is caused by Lewy body disease (McKeith et al, PMID: 16237129). There was also evidence of a right subdural hematoma, subarachnoid hemorrhage and cortical contusions consistent with a known antemortem fall.
