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vol.11 número4UM PAINEL DE CARACTERÍSTICAS CLÍNICAS E NEUROPATOLÓGICAS DA DOENÇA CEREBROVASCULAR ATRAVÉS DOS NOVOS MÉTODOS DE NEUROIMAGEMDEMÊNCIA MISTA: REVISÃO DAS EVIDÊNCIAS índice de autoresíndice de assuntospesquisa de artigos
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Dementia & Neuropsychologia

versão impressa ISSN 1980-5764versão On-line ISSN 1980-5764

Resumo

CHIMELLI, Leila. The role of biopsies and autopsies in the diagnosis of cognitive impairment, with emphasis on small vessel diseases: A critical appraisal enriched by personal experience. Dement. neuropsychol. [online]. 2017, vol.11, n.4, pp.356-363. ISSN 1980-5764.  https://doi.org/10.1590/1980-57642016dn11-040004.

Acquired and hereditary microangiopathies cause cerebral small vessel diseases (CSVD) that impair cognition. The most frequent is primary angiitis of the CNS (PACNS), whose diagnosis remains challenging, requiring a multidisciplinary approach. Secondary vasculitis, CADASIL, miscellaneous microangiopathies and lymphomas, also cause cognitive impairment. Despite the fact that the need for biopsy has decreased in the era of new neuroimaging methods, biopsies that include small leptomeningeal and parenchymal arterial vessels still remain the gold standard to diagnose PACNS and other CSVD, and to exclude mimics such as infections and malignancies. New approaches for pathological consequences relevant to vascular cognitive impairment such as silent brain lesions, microinfarcts, microbleeds and subtle loss of microstructural integrity, may be detected in autopsies. This article addresses the role of biopsies and autopsies for the diagnosis of cognitive impairment related to small vessel diseases or other inflammatory/ischemic processes, and presents a critical appraisal based on personal experience.

Palavras-chave : cognitive impairment; cerebral small vessel diseases; vasculitis; cerebral and meningeal biopsy; autopsy.

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