The acoustic cortex in vascular dementia: a Golgi and electron microscope study.

Morphological alterations in vascular dementia have been extensively described in the hippocampus, the cerebral cortex, the subcortical centers and the cerebellum. In the present study, we describe the morphological alterations of the acoustic cortex in five cases, which fulfilled the clinical, neuropsychological and laboratory diagnostic criteria of vascular dementia. The morphological alterations, seen in Golgi technique and electron microscopy concerned the capillaries, the dendritic arborization of the neurons, the astrocytes and the cytoarchitecture of the cortex. The neurons showed an impressive abbreviation of the dendritic fields and loss of spines. Astrocytic proliferation was seen in the cortex. The layer I showed marked decline of Cajal-Retzius cells. The majority of the synapses demonstrated changes in size and shape of the pre- and postsynaptic components and alterations of the organelles. The morphological alterations of the acoustic cortex in vascular dementia may be associated with the impairment of the verbal communication, which is not an uncommon phenomenon even in the early stages of the vascular dementia.