Congophilic angiopathy in the pathogenesis of Alzheimer's degeneration

The pathologic manifestations in 45 valid cases of Alzheimer's degeneration were evaluated with specific focus on the presence of Congophilic angiopathy. The latter lesion was found in 89% of the cases and had a definite temporal relationship to the presence of neuritic plaques and neurofibrillary tangles. Two types of plaques were defined, the neuritic and perivascular. The latter was associated spatially with vessels, but not neurofibrillary tangles, while the converse was true of the neuritic plaques. Based on the pattern of mural involvement of vessels, distinctions could be made to differentiate morphologically between cerebral and peripheral amyloid angiopathy. Alzheimer's degeneration appears to be a disease complex with a variety of etiologies. Little or no differences in morphologic characteristics between the presenium and senium process could be discerned. Congophilic angiopathy appears to be a major feature in the pathogenesis of Alzheimer's degeneration.