Neuropathological post-mortem examination of the brain and the spinal cord in ten key points – What can a neurologist expect from the neuropathologist’s confirmation of the clinical dia­gnosis in neurodegenerative dis­eases?

Authors: Z. Rohan 1,2;  R. Rusina 3,4;  R. Matěj 1,2
Authors‘ workplace: Oddělení patologie a národní referenční laboratoř TSE-CJN, Thomayerova nemocnice, Praha 1;  Ústav patologie, 1. LF UK a VFN v Praze 2;  Neurologická klinika a Centrum klinických neurověd 1. LF UK a VFN v Praze 3;  Oddělení neurologie, Thomayerova nemocnice, Praha 4
Published in: Cesk Slov Neurol N 2018; 81(1): 109-114
Category: Neuropathological window
doi: 10.14735/amcsnn2018109


Standardized brain and spinal cord autopsy is a key feedback mechanism for clinical diagnosis of neurodegenerative diseases. Clinical diagnostic criteria in neurodegenerative disorders reach the “possible” and “probable” levels. Neuropathological brain examination is often the only diagnostic modality able to confirm the “definite” level of diagnosis in dementia, behavior disorders and movement disorders and thus serves as an invaluable feedback for the clinician; and in clinical studies, it is used to assess therapy-related changes and validate potential diagnostic and prognostic biomarkers. The brain and spinal cord autopsy is performed following a standardized protocol analyzing all diagnostically relevant structures. Precise diagnostic procedures are performed using standard and special histological and histochemical staining; however, only a standardized set of special immunohistochemical investigations can confirm the precise neuropathological diagnosis in neurodegenerative diseases. The purpose of the article is to provide clinical neurologists in 10 points with a brief and practical overview about the usefulness of brain and spinal cord autopsy in neurodegenerative disease and about what the clinician can expect from the neuropathological protocol.

Key words:
dementia – neurodegenerative diseases – brain autopsy – brain biopsy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


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