AN AUTOPSY CASE OF COEXISTING PORTAL-SYSTEMIC ENCEPHALOPATHY AND SENILE DEMENTIA OF THE ALZHEIMER-TYPE

An autopsy case of portal systemic encephalopathy and senile dementia of the Alzheimer type coexisting in a 77-year-old man is described. Th e patient had suffered recurrent episodes of delirium after a subtotal gastrectomy for gastric carcinoma. He died of DIC 45 months after the gastrectomy. A pathological examination revealed a vascular plexus ar ound the liver which might have served as collateral circulation. Neur opathologically, spongy necrosis and Alzheimer type II changes of astr ocytes were found in the basal ganglia and fronto-occipital cortices. In the same anatomical regions, only immunohistological staining using antibody against amyloid beta-protein and the periodic-acid methenami ne silver method revealed abundant neuriticplaques, cerebral amyloid a ngiopathy and diffuse plaques. We discussed the clinicopathological fi ndings in this case.