Skip to main content Accessibility help
×
Home
Hostname: page-component-684899dbb8-4btjb Total loading time: 0.578 Render date: 2022-05-28T08:31:40.023Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

3 - Practical approach to pathological diagnosis

Published online by Cambridge University Press:  12 October 2009

Margaret M. Esiri
Affiliation:
Radcliffe Infirmary, Oxford, UK
James H. Morris
Affiliation:
John Radcliffe Hospital, Oxford, UK
Margaret M. Esiri
Affiliation:
University of Oxford
Virginia M. -Y. Lee
Affiliation:
University of Pennsylvania School of Medicine
John Q. Trojanowski
Affiliation:
University of Pennsylvania School of Medicine
Get access

Summary

The post-mortem examination in cases of dementia

It has been said, with a good deal of truth, that the answer to every question in medicine is in three parts: first, take a history, second, make a physical examination, and third, perform the relevant special tests and investigations. For the pathologist, the first two parts of this rubric are fulfilled by reading the patient's chart. The third is the performance of what, in at least one sense, is the ultimate diagnostic test, the post-mortem examination.

History and examination

The clinical information available to the pathologist called upon to perform an autopsy examination on a case of dementia is extraordinarily variable. At one extreme is the patient who has been studied over an extended period where the quality and extent of cognitive failure has been documented and, often, a presumptive pathological diagnosis is made. This type of history is often supplemented by more or less objective tests of intellectual function and the results of numerous investigations. Patients submitted to this degree of investigative rigour are often in centres that have a particular interest or active research programme into dementia. In these circumstances it can (we hope) be assumed that there is good liaison between the clinical service and the pathology department and the cases will be dealt with according to protocol.

The opposite end of this particular spectrum is the patient coming to autopsy examination who is reported to have an unspecified degree of cognitive decline, variously described in imprecise terms. In such cases recourse to considerable ingenuity is required to form an idea of the nature and severity of the decline. Clues can sometimes be gleaned from the nursing notes or even from the patient's address.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×