Fig. 2. (A, B) At autopsy, the brain weight was 1290 gm and mild global atrophy was seen. (C, D) The circle of Willis showed severe atherosclerosis with luminal occlusion in more than 50% of the lumen, which is severity score 3 according to the vascular cognitive impairment neuropathological guidline (VCING) criteria. (E) Luxol fast blue stain section showed hyalinization of arterioles with perivascular dilatation and white matter rarefaction, compatible with small vessel disease (arteriolosclerosis). There were corpora amylacea in the white matter adjacent to arteriosclerotic vessels, suggesting parenchymal damage by arteriolosclerosis. (F) Immunohistochemical analysis with phosphorylated tau revealed positive neurofibrillary tangles, neuropil threads in the temporal lobe (Braak stage III/VI), as well as classic amyloid cored plaques (shown in the inlet) that were present in the whole neocortex, hippocampus, thalamus, amygdala, basal ganglia, and midbrain (Thal phase was 4/5). Therefore, the patient had an intermediate level of Alzheimer’s neuropathologic change by neuropathological National Institute on Aging and the Alzheimer’s Association (NIA-AA) criteria (A3, B2, C2) (Under bar scale: D: 500 μm, E: 50 μm, F: 5 mm).
© Exp Neurobiol
