Open AccessHereditary Cerebral Hemorrhage with Amyloidosis‐Dutch Type (HCHWA‐D): I ‐ A Review of Clinical, Radiologic and Genetic Aspects
Author(s) -
Bornebroek Marjolijn,
Haan Joost,
MaatSchieman Marion LC,
Duinen Sjoerd G Van,
Roos Raymund AC
Publication year - 1996
Publication title -
brain pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.986
H-Index - 132
eISSN - 1750-3639
pISSN - 1015-6305
DOI - 10.1111/j.1750-3639.1996.tb00793.x
Subject(s) - cerebral amyloid angiopathy , perivascular space , pathology , medicine , dementia , amyloidosis , hyperintensity , stroke (engine) , amyloid (mycology) , parenchyma , alzheimer's disease , white matter , disease , magnetic resonance imaging , radiology , mechanical engineering , engineering
Hereditary cerebral hemorrhage with amyloidosis ‐ Dutch type (HCHWA‐D) is an autosomal dominant disease caused by deposition of β‐amyloid in the leptomeningeal arteries and cortical arterioles, in addition to preamyloid deposits and amyloid plaques in the brain parenchyma. The disease is due to a point mutation at codon 693 of the amyloid precursor protein (βPP) gene at chromosome 21. Since this point mutation is diagnostic for HCHWA‐D, presymptomatic testing is feasible and offered, together with genetic counselling and psychological support, to subjects at risk. HCHWA‐D is clinically characterized by recurrent strokes, in addition to dementia, which can occur after the first stroke but also preceding it. Radiological studies revealed focal lesions (hemorrhages, hemorrhagic and non‐hemorrhagic infarctions) and diffuse white matter damage. Diffuse white matter hyperintensities on MRI are an early symptom of HCHWA‐D since they have been found on MRI scans of subjects who had not suffered a stroke. The presence of the diagnostic point mutation makes HCHWA‐D a useful model to study the effects of cerebral amyloid angiopathy in vivo. The characteristic pathological abnormalities and its implications for Alzheimer's disease will be discussed in Part II of this article