Correspondence

Hippocampal sclerosis (HS) is a common and often asymmetric neuropatho-logical finding among elderly persons who experience progressive memory loss, but its cause is unknown and it is rarely diagnosed during life. In order to improve both understanding and diagnosis of late-life HS, bilateral hippocampi and cerebral hemispheres were reviewed in 130 consecutive autopsy cases drawn from a longitudinal study of subjects with subcortical ischemic vascular demen-tia (IVD), Alzheimer disease (AD) and normal aging. HS was found in 31 of 130 cases (24.5%). Of these, 45 % were bilateral, 32 % left-sided, and 23 % right-sided. The majority of HS cases involved the entire rostral-caudal extent of the hippocampus. However, in 7 cases HS was focal in nature and was only found at or anterior to the lateral geniculate nucleus. In 77 % of cases, HS was accom-panied by other types of pathology (‘mixed ’ HS), but in 23 % of cases it was the sole neuropathologic finding (‘pure ’ HS). TDP-43-positive cytoplasmic inclusions were found in dentate granule cells in 93 % of all HS cases, 55 % o