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CADASIL patient (sural nerve biopsy)

Hematoxylin and eosin stain of a sural nerve biopsy reveals the deposition of eosinophilic material within the media of vessel walls. The accumulating material replaces the smooth muscle cells in the media. Because the arteriopathy of CADASIL affects the vessels of the skin in a manner similar to that observed in the sural nerve, biopsy of either the skin or sural nerve can be used to diagnose CADASIL. (Contributed by Dr. Steve Moore and Dr. Jill Hagenkord of the University of Iowa Department of Pathology.)

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