Figure 6
From: Clinical, imaging, and pathological heterogeneity of the Alzheimer's disease syndrome
White matter hyperintensities in Alzheimer's disease. A 68 year old man presenting with short-term memory decline. Imaging done 7 years into the course of illness, including axial T1 MRI at the level of the centrum semiovale (upper left), demonstrated severe generalized atrophy. Axial T2 (top right) and proton density (bottom left) images at the same level showed marked white matter hyperintensities, especially posteriorly (white arrows). One year prior, axial single-photon emission computed tomography (SPECT) at the corresponding level (bottom right) demonstrated mild parietal hypoperfusion bilaterally (red arrows). The patient died 9 years later and autopsy confirmed Alzheimer's disease (Braak V/VI), with diffuse atherosclerosis throughout the white matter and basal ganglia, lacunar infarcts, remote microhaemorrhages and cortical microinfarcts. There had been no history of visual hallucinations, but parkinsonism developed very late into the disease course, and he was also found to have diffuse Lewy bodies within the brain stem and cingulum.