Cerebral amyloid angiopathy

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[edit] Discussion of Cerebral amyloid angiopathy

  • Cerebral amyloid angiopathy (CAA) is an important cause of spontaneous cortical-subcortical intracranial hemorrhage (ICH) in the normotensive elderly.
  • Characterized by the deposition of ß-amyloid protein in the media and adventitia of small and medium-sized vessels of the cerebral cortex, subcortex, and leptomeninges.
  • Both prevalence and severity with increases age (CAA is found in 33% of 60–70 year olds and 75% of those older than 90 years).
  • CAA is underrecognized cause of cerebrovascular disease, clinically as well as at imaging, because many patients are asymptomatic and symptoms are nonspecific.
  • Most common presentation of CAA is the development of a sudden neurologic deficit secondary to an acute ICH.
  • Dementia in CAA may be seen prior to symptomatic ICH in 25%–40% of patients.

[edit] Imaging Findings for Cerebral amyloid angiopathy

  • CAA manifests radiologically as part or all of a constellation of findings including:
    • Acute or chronic ICHs in a distinctive cortical-subcortical distribution
    • Leukoencephalopathy
    • Atrophy

  • CT allows rapid establishment of the presence or absence of an ICH and exclusion of an acute cerebral infarction.
  • Nonenhanced head CT is the preferred imaging modality for initial work-up as it provides crucial information regarding the characteristics of the ICH, including size, location, shape, and extension to the extraaxial spaces
  • If an ICH is present in a cortical-subcortical location suspicious for CAA, the patient should undergo additional evaluation with MR imaging.
  • GRE is currently the most sensitive MR imaging sequence for detection of the chronic cortical-subcortical microhemorrhage.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

[edit] References for Cerebral amyloid angiopathy