“The question we were asked was ‘What was the etiology of the dementia?’” the pathologist took up where Dr. Fleming left off. A slide showing a cross-section of Dad’s whole brain was up on the screen. I hoped Mom was OK, but was afraid if I looked at her, it would get us both upset. I concentrated on taking notes, and tried not to think about it.
“So here’s the brain - you can see the large hemorrhage on the right side.” I was relieved when he moved on to a slide showing a microscopic view. He moved to the next slide and another pathologist spoke up. “I looked at these slides with Joe. This shows thickening of the vessel walls….”
He launched into a detailed discussion of why it was hard to figure out what caused Dad’s blood vessel disease.
Fifteen minutes into the presentation, I started to see why the cardiovascular surgeon on the plane had warned me not to expect a lot of answers. The pathology slides showed that Dad’s microbleeds were probably from thickening and degeneration of the walls of the small blood vessels in his brain. But it wasn’t clear what caused that problem or whether the microbleeds caused his dementia.
Are all dementia autopsies so complicated?