COMBINED AMYLOID VASCULAR CHANGES AND ARGYROPHILIC PLAQUES IN THE CENTRAL NERVOUS SYSTEM

In the course of an investigation on the prevalence of Alzheimer's disease at St. Elizabeths Hospital (1), a case was encountered in which the prominence of argyrophilic plaques and the lack of significant mental changes seemed in striking variance with the findings of other cases in the series. In contrast to the usual picture, the plaques in this case were visible with practically every staining method employed. Many of the plaques were larger, and the silver stained granules composing them coarser, than those seen in the brains of individuals showing progressive degenerative mental changes. Another interesting feature was the presence of hyaline-like changes in the walls of many small arteries; the large vessels in contrast were free from degenerative changes. Although the patient died as the result of a massive cerebral hemorrhage, and had suffered an earlier hemorrhage in the right motor area, there had been no clinical evidence of hypertension. Similar pathologic findings have been reported in the literature by Worster-Drought, Greenfield and McMenemey (2, 3) and by Corsellis and Brierly (4). In addition to the plaques and widespread vascular alterations, neurofibrillary changes were found in their cases, so that they were reported as unusual examples of presenile dementia. Because of the seeming rarity of the condition and the dissimilarity of the clinical signs in the reported case and those previously described, it is deemed of importance to add this case to the literature.