Hereditary cerebral hemorrhage with amyloidosis-Dutch type: better correlation of cognitive deterioration with advancing age than with number of focal lesions or white matter hyperintensities.

[hereditary cerebral hemorrhage with amyloidosis]

The relationship between cognitive deterioration and abnormalities detected by magnetic resonance imaging (MRI ) was investigated to determine the radiological correlates of cognitive deterioration in hereditary cerebral hemorrhage with amyloidosis -Dutch type (HCHWA-D ). Twenty HCHWA-D subjects (12 patients who had suffered one or more strokes and eight who had not suffered a stroke ) were studied with MRI and underwent extensive neuropsychological examination . On MRI the number of focal lesions was counted , and white matter hyperintensities (WMHs ) were scored semiquantitatively . A significant correlation between cognitive deterioration and WMH score and number of focal lesions was found . However , cognitive deterioration , WMH score , and the number of focal lesions all increase with age , and therefore their mutual correlation can be explained as an age effect . This study shows that cognitive deterioration in HCHWA-D is not correlated with abnormalities detected by MRI (number of focal lesions and subcortical WMHs ) independently of age . Although a contribution of white matter changes and /or focal lesions , possibly in combination with age , to cognitive deterioration can not be excluded . Cognitive deterioration in these HCHWA-D patients is probably primarily the result of chronic damage of amyloid angiopathy to the brain , to which may be superimposed cognitive impairment from focal cerebral hemorrhage or infarction .