Structural modifications of intracerebral small vessels in various types of dementia.

Previous and recent studies stress the importance of small intracerebral vessel lesions in the pathogeny of some forms of dementia. The observations on this subject and included in our study refer to adult patients (32-86 years) selected only on the criterion of clinical diagnosis of dementia. To diagnose most of the cases, clinical experimental data and clinico-psychomotor tests were used. Classical neuropathological techniques were performed for the morphological study of their brains. All types of cerebral vessels were affected in various percentages by the different types of lesions. Vessel wall sclerosis of all types of intracerebral vessels was noticed in 50% of the cases, the thickening of the arteriolar wall with or without sclerosis in 25% of cases and exclusively capillary fibrosis in 21.4% of cases. Other types of vascular changes were present in a small number of cases. No correlation could be made between a certain type of vascular lesion and the age or diagnosis of the patient. Nevertheless, we could observe that wall sclerosis was more frequently found in groups with the oldest patients with vascular diseases (VD, MD), the thickening of the arteriolar wall in patients aged 60-74 years with vascular diseases, and capillary changes in older patients with dementia of Alzheimer type. No preferential location of the vascular lesions could be observed in our group of patients.