%0 Case Reports
%T Mixed Small Vessel Disease in a Patient with Dementia with Lewy Bodies.
%A Paraskevas GP
%A Constantinides VC
%A Pyrgelis ES
%A Kapaki E
%J Brain Sci
%V 9
%N 7
%D Jul 2019 4
%M 31277472
%F 3.333
%R 10.3390/brainsci9070159
%X 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.
CONCLUSIONS: 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.