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To identify those patients most likely to benefit from a cerebral biopsy to diagnose dementia,we reviewed a series of 14 unselected biopsies performed during a 9-year period(1980 through 1989)at Duke University Medical Center,Durham,NC.Pathognomonic features allowed a definitive diagnosis in seven specimens.Nondiagnostic abnormalities but not diagnostic neuropathologic changes were seen in five additional specimens, and two specimens were normal.Creutzfeldt-Jakob disease was the most frequent diagnosis.One patient each was diagnosed as having Alzheimer's disease,diffuse Lewy body disease,adult-onset Niemann-Pick disease,and anaplastic astrocytoma.We conclude that a substantial proportion of patients presenting clinically with atypical dementia are likely to receive a definitive diagnosis from a cerebral biopsy.However,in those with coexisting hemiparesis,chorea,athetosis,or lower motor neuron signs, cerebral biopsies are less likely to be diagnostic. |
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brain biopsy brain biopsy,complications of brain biopsy,false negative brain biopsy,indication dementia dementia,diagnostic evaluation of Jakob-Creutzfeldt disease Lewy body disease,diffuse lipid storage disorder of CNS Niemann-Pick disease
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