Cerebral amyloid angiopathy (case report)

Abstract

Cerebral amyloid angiopathy (CAA) is characterized by -amyloid deposition in cortical and leptomeningeal arteries of small and medium size that disturbs normal structure of arterial wall. CAA is one of the often causes of peripheral intracerebral hemorrhages and cognitive impairment in old patients. We describe male patient, 52 years with CAA. Clinical picture was characterized by recurrent cortical-subcortical (lobar) hemorrhages, cognitive impairment of subcortiical type and epileptic seizures. MRI revealed superficial posthemorrhagic lesions. Gradient-echo MRI found small multiple asymptomatic hemorrhages in cerebral cortex and subcortical matter. Repeatgradientecho MRI carried out monthes revealed new clinically asymptomatic hemorrhages. Arterial hypertension as a cause of intracerebral hemorrhage was excluded on the base of atypical location of hemorrhage (superficial, but not deep). CAA diagnosis was made according to international Boston criteria: multiple lobar, cortical-subcortical hemorrhages not connected with other definite cause of intracerebral hemorrhage. Gradient-echo MRI is of a great importance in diagnosis of CAA, as it discovers small cortical and superficial hemorrhages, none detected by standard MRI regimes.

Keywords

• cerebral amyloid angiopathy
• lobar hemorrhages
• cognitive impairment