Davous P, Bequet D
Service de Neurologie, Centre Hospitalier, Argenteuil.
Rev Neurol (Paris). 1995 Nov;151(11):634-9.
We report 3 cases of Cadasil with dementia. In the 3 cases, the dementia had a subcortical and frontal presentation. It associated behavioural symptoms, amnesia, executive functions disturbances, bradyphrenia, slowing of information processing and frontal symptoms, without aphasia, apraxia or agnosia. One patient showed overt dementia before any focal neurological sign. Imaging of the brain was consistent with subcortical infarcts and leukoencephalopathy, without involvement of the cerebral cortex. We suggest that dementia and psychoaffective disturbances are major diagnostic criteria for Cadasil. This pathology is probably a good model for the neuropsychological study and the physiopathological analysis of the concept of subcortical dementia.
我们报告了3例伴有痴呆的伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病(CADASIL)。在这3例病例中,痴呆具有皮质下和额叶表现。它伴有行为症状、失忆、执行功能障碍、思维迟缓、信息处理速度减慢和额叶症状,无失语、失用或失认。1例患者在出现任何局灶性神经体征之前就表现出明显的痴呆。脑部影像学检查结果与皮质下梗死和白质脑病相符,未累及大脑皮质。我们认为痴呆和精神情感障碍是CADASIL的主要诊断标准。这种病理情况可能是皮质下痴呆概念的神经心理学研究和病理生理分析的良好模型。