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Open AccessCase Report

Mixed Small Vessel Disease in a Patient with Dementia with Lewy Bodies

1st Department of Neurology, Cognitive and Movement Disorders clinic and Unit of Neurochemistry and Biological Markers, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 10679 Athens, Greece
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Brain Sci. 2019, 9(7), 159; https://doi.org/10.3390/brainsci9070159
Received: 24 May 2019 / Revised: 25 June 2019 / Accepted: 2 July 2019 / Published: 4 July 2019
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Abstract

Background: Cerebral amyloid angiopathy (CAA) is characterized by deposition of amyloid in small/medium size brain vessels, and may coexist with Alzheimer’s disease or dementia with Lewy bodies (DLB). We describe a patient with a clinical diagnosis of DLB and imaging/biochemical characteristics suggestive of mixed small vessel disease (both CAA and non-amyloid microangiopathy). Methods: Clinical evaluation according to recent diagnostic criteria, magnetic resonance imaging, dopamine-transporter scan (DAT-scan) and cerebrospinal fluid (CSF) analysis for dementia biomarkers were all performed. Results: The patient is a 71-year-old male, fulfilling criteria for probable DLB, with a positive DAT-scan, but with multiple microbleeds in a cortical-subcortical location suggestive of CAA, some microbleeds in deep brain nuclei suggestive of non-amyloid microangiopathy and abnormal levels of only amyloid-beta (Aβ42) in CSF. Conclusion: Coexistent mixed vascular and neurodegenerative disorders are frequent in older subjects with dementia and each one of the underlying pathologies may contribute to, or modify the clinical presentation. View Full-Text
Keywords: cerebral amyloid angiopathy; subcortical small vessel disease; dementia with Lewy bodies; amyloid beta; cerebrospinal fluid biomarkers cerebral amyloid angiopathy; subcortical small vessel disease; dementia with Lewy bodies; amyloid beta; cerebrospinal fluid biomarkers
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Paraskevas, G.P.; Constantinides, V.C.; Pyrgelis, E.-S.; Kapaki, E. Mixed Small Vessel Disease in a Patient with Dementia with Lewy Bodies. Brain Sci. 2019, 9, 159.

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