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Titolo:
Neuropathology of Alzheimer's disease and other dementias
Autore:
Dickson, DW;
Indirizzi:
Mayo Clin Jacksonville, Dept Pathol Neuropathol, Jacksonville, FL 32224 USA Mayo Clin Jacksonville Jacksonville FL USA 32224 cksonville, FL 32224 USA
Titolo Testata:
CLINICS IN GERIATRIC MEDICINE
fascicolo: 2, volume: 17, anno: 2001,
pagine: 209 -
SICI:
0749-0690(200105)17:2<209:NOADAO>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROGRESSIVE SUPRANUCLEAR PALSY; LEWY BODY DISEASE; CREUTZFELDT-JAKOB-DISEASE; CORTICOBASAL DEGENERATION; PARKINSONS-DISEASE; ALPHA-SYNUCLEIN; PICKS-DISEASE; SPONGIFORM ENCEPHALOPATHIES; FRONTOTEMPORAL DEMENTIA; DIAGNOSTIC-CRITERIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
59
Recensione:
Indirizzi per estratti:
Indirizzo: Dickson, DW Mayo Clin Jacksonville, Dept Pathol Neuropathol, Birdsall 317,4500 San Pablo Rd, Jacksonville, FL 32224 USA Mayo Clin Jacksonville Birdsall 317,4500 San Pablo Rd Jacksonville FL USA 32224
Citazione:
D.W. Dickson, "Neuropathology of Alzheimer's disease and other dementias", CLIN GERIAT, 17(2), 2001, pp. 209

Abstract

The clinical diagnosis of Alzheimer's disease (AD) is correct 75% to 90% of the time.(42) Accuracy is highest for neurologists specializing in memorydisorders and lowest for general practitioners, who tend to overdiagnose AD. The clinical accuracy is also lower for older patients, who often have mixed pathology rather than a single cause of dementia.(41) The clinical presentation and the course of AD can be stereotypic,(51) but the only currentmeans of establishing a definite diagnosis is by microscopic examination of brain tissue. There are no laboratory tests, including sophisticated imaging techniques and detailed neuropsychological evaluations, that are specific for AD. Brain tissue can be obtained for diagnostic evaluation by eithera biopsy or an autopsy. Biopsies are most often restricted to individuals with atypical presentations or an unusually rapid course. The major difficulty with clinical diagnosis of AD lies not in differentiating AD from normal, but rather in differentiating AD from other diseases that produce dementia. There are at least 60 different diseases that can produce dementia.(27) Although some of these disorders can be diagnosed with laboratory evaluations or imaging studies, an autopsy offers the only way todifferentiate unequivocally among the various disorders. In addition, the central nervous system autopsy provides feedback to clinicians involved in the care of the patient, which is a vital form of quality control that serves to improve the diagnostic acumen of the clinician. In addition, autopsies for dementia provide material for basic and clinicopathologic research. None of the major religions strictly prohibits autopsy studies especially when the autopsy offers benefits to subsequent generations.(22) On the other hand, some orthodox religions may limit the amount of tissue that can be removed for evaluation, or insist that unused tissue be returned to the body A brain autopsy usually requires less than 30 minutes to perform and doesnot delay the funeral. The brain autopsy is not disfiguring. The skin is incised behind the hairline so that the incision is not visible. The cranialbone is opened with a vibrating saw. The entire brain is removed. Because different regions of the brain are affected in AD and other disorders that can be mistaken for AD, an accurate postmortem diagnosis requires examination of the entire brain. A limited sampling is not recommended, but in extenuating circumstances, restricted autopsies are performed. Autopsy restrictions may impose limitations that may preclude an accurate diagnosis. The brain is often dissected at the time of the autopsy, and part of it is immediately frozen for biochemical and genetic analyses. The remaining tissue is used for diagnosis, teaching, and research.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 15:40:47