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Washington University Experience | VASCULAR | Infarct - Hemorrhagic | 6A0 Case 6 History
Case 6 History ---- This 72-year-old woman was seen on 8/21/89 with her daughter-in-law serving as a collateral source. Her medical history included Parkinson’s disease which was diagnosed in 1986 and treated with Sinemet. There was no evidence of dementia from 1990-2003. In 1995, she had a myocardial infarction, triple bypass, and stent placement. Treatment for hypertension was initiated. In 2001, she had colon surgery for a nonmetastatic malignancy and had a TIA during which she became weak and passed out. There were no residual neurological deficits. Her PD symptoms had increased so that she was bothered by a tremor in her left arm and leg as well as some postural instability but no changes in memory or thinking. In 2004, she moved to an independent senior living apartment until 2009 when she entered an assisted living facility. On 11/25/10, she fell and developed a subdural hematoma, requiring placement in a skilled nursing facility. She died on 12/12/10 at age 94 of “natural causes”. She was taking medicines for diabetes, hypertension, hypercholesterolemia, hypothyroidism, and Parkinson’s disease. ---- At autopsy the fresh (unfixed) brain weighed 1,165g. The main neuropathological findings in this case were early Alzheimer's disease neuropathologic changes (low probability by NIA-Reagan criteria), argyrophilic grain disease, but surprisingly no evidence of Lewy bodies, and infarction of a region in the left cerebellar hemisphere, with secondary hemorrhagic conversion.
