Cerebral amyloid angiopathy presenting as multiple intracranial lesions on magnetic resonance imaging

1991 ◽  
Vol 75 (3) ◽  
pp. 458-460 ◽  
Author(s):  
Deepak Awasthi ◽  
Rand M. Voorhies ◽  
John Eick ◽  
William T. Mitchell
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Intracerebral Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Amyloid Angiopathy ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Normotensive Patient ◽  
Content Type ◽  
Imaging Characteristics ◽  
Cerebral Amyloid

✓ Cerebral amyloid angiopathy is recognized as an important cause of spontaneous intracerebral hemorrhage in the elderly normotensive patient. Magnetic resonance (MR) imaging characteristics of this disease entity are rarely mentioned in the literature. The MR imaging findings of an elderly normotensive patient presenting with an acute spontaneous intracerebral hemorrhage secondary to amyloid angiopathy are reported and a brief review of amyloidosis is presented.

Intracerebral hemorrhage due to cerebral amyloid angiopathy

1985 ◽  
Vol 63 (6) ◽  
pp. 965-969 ◽  
Author(s):  
Norbert Roosen ◽  
Jean-Jacques Martin ◽  
Christian De La Porte ◽  
Michel Van Vyve
Keyword(s):  
Intracerebral Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Clinicopathological Features ◽  
Amyloid Angiopathy ◽  
Correct Treatment ◽  
Content Type ◽  
Cerebral Amyloid ◽  
Occipital Lobes ◽  
The Relationship ◽  
Fine Print

✓ The case is presented of a 59-year-old man with cerebral amyloid angiopathy and three consecutive hemorrhages in the occipital lobes. The clinicopathological features and the relationship to Alzheimer's dementia are discussed. The correct treatment of intracerebral hemorrhage related to cerebral amyloid angiopathy is a matter of controversy.

Idiopathic primary intraventricular hemorrhage and cerebral small vessel disease

2021 ◽  
pp. 174749302110439
Author(s):  
Alvin S Das ◽  
Robert W Regenhardt ◽  
Elif Gokcal ◽  
Mitchell J Horn ◽  
Nader Daoud ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intracerebral Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Intraventricular Hemorrhage ◽  
Brain Magnetic Resonance Imaging ◽  
Amyloid Angiopathy ◽  
Resonance Imaging ◽  
The Mean ◽  
Cerebral Amyloid

Background Although primary intraventricular hemorrhage is frequently due to trauma or vascular lesions, the etiology of idiopathic primary intraventricular hemorrhage (IP-IVH) is not defined. Aims Herein, we test the hypothesis that cerebral small vessel diseases (cSVD) including hypertensive cSVD (HTN-cSVD) and cerebral amyloid angiopathy are associated with IP-IVH. Methods Brain magnetic resonance imaging from consecutive patients (January 2011 to September 2019) with non-traumatic intracerebral hemorrhage from a single referral center were reviewed for the presence of HTN-cSVD (defined by strictly deep or mixed-location intracerebral hemorrhage/cerebral microbleeds) and cerebral amyloid angiopathy (applying modified Boston criteria). Results Forty-six (4%) out of 1276 patients were identified as having IP-IVH. Among these, the mean age was 74.4 ± 12.2 years and 18 (39%) were females. Forty (87%) had hypertension, and the mean initial blood pressure was 169.2 ± 40.4/88.8 ± 22.2 mmHg. Of the 35 (76%) patients who received a brain magnetic resonance imaging, two (6%) fulfilled the modified Boston criteria for possible cerebral amyloid angiopathy and 10 (29%) for probable cerebral amyloid angiopathy. Probable cerebral amyloid angiopathy was found at a similar frequency when comparing IP-IVH patients to the remaining patients with primary intraparenchymal hemorrhage (P-IPH) (27%, p = 0.85). Furthermore, imaging evidence for HTN-cSVD was found in 8 (24%) patients with IP-IVH compared to 209 (28%, p = 0.52) patients with P-IPH. Conclusions Among IP-IVH patients, cerebral amyloid angiopathy was found in approximately one-third of patients, whereas HTN-cSVD was detected in 23%—both similar rates to P-IPH patients. Our results suggest that both cSVD subtypes may be associated with IP-IVH.

scholarly journals Ambient Pollutants and Spontaneous Intracerebral Hemorrhage in Greater Boston

Stroke ◽  
2018 ◽  
Vol 49 (11) ◽  
pp. 2764-2766
Author(s):  
Elissa H. Wilker ◽  
Elizabeth Mostofsky ◽  
Alan Fossa ◽  
Petros Koutrakis ◽  
Andrew Warren ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Nitrogen Dioxide ◽  
Black Carbon ◽  
Cerebral Amyloid Angiopathy ◽  
Odds Ratio ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Amyloid Angiopathy ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Cerebral Amyloid

Background and Purpose— Associations between exposures to ambient air pollution and spontaneous intracerebral hemorrhage (ICH) have been inconsistent, and data on stroke subtypes are currently limited. Methods— We obtained information on all cases of deep or lobar hematomas from ICH patients who were admitted to the Massachusetts General Hospital in Boston, MA, between 2006 and 2011. We linked the date of admission with 1- to 7-day moving averages of fine particulate matter (PM 2.5 ), black carbon, nitrogen dioxide, and ozone from area monitors. We conducted time-stratified bidirectional case-crossover analyses to assess associations between pollutants and stroke. We also investigated whether associations differed by hemorrhage location and type. Results— There were 577 cases of ICH (295 deep, 282 lobar). Overall, there was no evidence of elevated ICH risk after increases in PM 2.5 , black carbon, or nitrogen dioxide in the whole population. However, there was suggestion of heightened risk with higher levels of ozone for averages longer than 1 day although CIs were wide. In models stratified by ICH location, associations with ozone remained positive for patients with lobar (3-day moving average odds ratio, 1.62; 95% CI, 1.18–2.22) but not deep ICH (odds ratio, 0.88; 95% CI, 0.65–1.20). Larger estimates were observed among participants with a probable diagnosis of cerebral amyloid angiopathy (odds ratio, 2.23; 95% CI, 1.25–3.96). Conclusions— Exposure to ozone may be associated with incidence of lobar ICH, especially among those who have confirmed or probable cerebral amyloid angiopathy.

Cerebral amyloid angiopathy with multiple intracerebral hemorrhages

1982 ◽  
Vol 57 (2) ◽  
pp. 286-289 ◽  
Author(s):  
Kenneth L. Tyler ◽  
Charles E. Poletti ◽  
Roberto C. Heros
Keyword(s):  
Intracerebral Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Neurological Disorders ◽  
Brain Parenchyma ◽  
Amyloid Angiopathy ◽  
Content Type ◽  
Intracerebral Hemorrhages ◽  
Cerebral Amyloid ◽  
Unclear Etiology ◽  
Adjacent Brain

✓ Cerebral amyloid angiopathy (CAA) has been associated with atypical dementia and a variety of other neurological disorders. Intracerebral hemorrhage is the most striking manifestation of CAA. A 63-year-old patient is described who sustained four intracerebral hemorrhages although he had no predisposing factors other than CAA. The neurological and pathological features of CAA are reviewed, with particular emphasis on the problem of CAA-associated intracerebral hemorrhage. On the basis of the experience with this case, it is recommended that adjacent brain parenchyma be biopsied in all patients undergoing evacuation of intracerebral hematomas of unclear etiology.

Cerebellar Superficial Siderosis in Cerebral Amyloid Angiopathy

Stroke ◽  
2021 ◽  
Author(s):  
Emma A. Koemans ◽  
Sabine Voigt ◽  
Ingeborg Rasing ◽  
Thijs W. van Harten ◽  
Wilmar M.T. Jolink ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Relative Risk ◽  
Magnetic Resonance ◽  
Intracerebral Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Median Number ◽  
Superficial Siderosis ◽  
Amyloid Angiopathy ◽  
Resonance Imaging ◽  
Cerebral Amyloid

Background and Purpose: Although evidence accumulates that the cerebellum is involved in cerebral amyloid angiopathy (CAA), cerebellar superficial siderosis is not considered to be a disease marker. The objective of this study is to investigate cerebellar superficial siderosis frequency and its relation to hemorrhagic magnetic resonance imaging markers in patients with sporadic and Dutch-type hereditary CAA and patients with deep perforating arteriopathy–related intracerebral hemorrhage. Methods: We recruited patients from 3 prospective 3 Tesla magnetic resonance imaging studies and scored siderosis and hemorrhages. Cerebellar siderosis was identified as hypointense linear signal loss (black) on susceptibility-weighted or T2*-weighted magnetic resonance imaging which follows at least one folia of the cerebellar cortex (including the vermis). Results: We included 50 subjects with Dutch-type hereditary CAA, (mean age 50 years), 45 with sporadic CAA (mean age 72 years), and 43 patients with deep perforating arteriopathy–related intracerebral hemorrhage (mean age 54 years). Cerebellar superficial siderosis was present in 5 out of 50 (10% [95% CI, 2–18]) patients with Dutch-type hereditary CAA, 4/45 (9% [95% CI, 1–17]) patients with sporadic CAA, and 0 out of 43 (0% [95% CI, 0–8]) patients with deep perforating arteriopathy–related intracerebral hemorrhage. Patients with cerebellar superficial siderosis had more supratentorial lobar (median number 9 versus 2, relative risk, 2.9 [95% CI, 2.5–3.4]) and superficial cerebellar macrobleeds (median number 2 versus 0, relative risk, 20.3 [95% CI, 8.6–47.6]) compared with patients without the marker. The frequency of cortical superficial siderosis and superficial cerebellar microbleeds was comparable. Conclusions: We conclude that cerebellar superficial siderosis might be a novel marker for CAA.

Lobar intracerebral hemorrhage

1992 ◽  
Vol 76 (2) ◽  
pp. 231-238 ◽  
Author(s):  
Susumu Wakai ◽  
Nahomi Kumakura ◽  
Masakatsu Nagai
Keyword(s):  
Intracerebral Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Vascular Malformation ◽  
Cavernous Malformation ◽  
Ct Scans ◽  
Amyloid Angiopathy ◽  
Content Type ◽  
Negative Angiography ◽  
Cerebral Amyloid ◽  
Fine Print

✓ The authors operated consecutively on 50 patients with lobar intracerebral hemorrhage during a prospectively designed study period from January, 1986, to March, 1990. They investigated the correlations between the underlying causes and the clinicoradiographic features in 29 patients who showed no angiographic vascular abnormalities, in order to elucidate the operative indication for such cases. Patients with ruptured saccular aneurysm or trauma were not included in this study. There were 15 males and 14 females, ranging in age from 7 to 76 years (mean 52.4 years). Histological diagnoses of the surgical specimens were as follows: vascular malformation in nine cases (arteriovenous malformation (AVM) in six and cavernous malformation in three), microaneurysm in 11, cerebral amyloid angiopathy in six, and brain tumor in two; in the remaining case the cause was not verified histologically. The underlying cause was determined in 96.5% of cases. The mean patient age was lowest in the cavernous malformation group (27.0 years), followed by the AVM (45.8 years), microaneurysm (59.8 years), and cerebral amyloid angiopathy (70.0 years) groups. Four patients with vascular malformation (three AVM's and one cavernous malformation) had previous episodes of bleeding at the same site, whereas none of those with microaneurysms or cerebral amyloid angiopathy had such episodes. On computerized tomography (CT) scans, the round to oval hematoma was related to the presence of an AVM or cavernous malformation in contrast to microaneurysms and cerebral amyloid angiopathy. Upon infusion of contrast material, variable enhancement was seen in five (two AVM's and three cavernous malformations) of the nine vascular malformations while no enhancement was noted in any patient with microaneurysm or cerebral amyloid angiopathy at the acute stage. Subarachnoid extension of the hematoma was associated with cerebral amyloid angiopathy significantly more frequently than with AVM's (p < 0.05) and microaneurysms (p < 0.01). The results suggest that clinicoradiographic pictures in cases with negative angiography are quite different among the three major pathological categories; namely, vascular malformation (AVM and cavernous malformation), microaneurysm, and cerebral amyloid angiopathy. It is suggested that the underlying etiology of a given lobar intracerebral hemorrhage with negative angiography may be predicted by a combination of patient age, history of previous bleeding at the same site, hematoma shape, and subarachnoid extension of the hematoma on CT scans. Based upon these findings, the authors discuss operative indications for such cases.

Cerebral Amyloid Angiopathy-related Intracerebral Hemorrhage Score For Predicting Outcome

2016 ◽  
Vol 13 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Chunyan Lei ◽  
Bo Wu ◽  
Ming Liu ◽  
Shuting Zhang ◽  
Ruozhen Yuan
Keyword(s):  
Intracerebral Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Amyloid Angiopathy ◽  
Predicting Outcome ◽  
Cerebral Amyloid

scholarly journals 10-Year Follow-Up of a Patient with Cerebral Amyloid Angiopathy

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 202-206
Author(s):  
Min Kyoung Kang ◽  
Byung-Woo Yoon
Keyword(s):  
Cerebral Amyloid Angiopathy ◽  
The Elderly ◽  
Amyloid Angiopathy ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Radiological Features ◽  
Magnetic Imaging ◽  
Long Term Follow Up ◽  
Cerebral Amyloid

We report the case of long-term follow-up of brain magnetic imaging of cerebral amyloid angiopathy. Cerebral amyloid angiopathy is often considered a major cause of spontaneous intracerebral hemorrhage in the elderly. This case illustrates the markedly progressive clinical and radiological features of the vasculopathic process in 10 years.

scholarly journals Post-Mortem 7.0-Tesla Magnetic Resonance Imaging of the Hippocampus in Progressive Supranuclear Palsy with and without Cerebral Amyloid Angiopathy

NeuroSci ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 115-120
Author(s):  
Jacques De Reuck ◽  
Florent Auger ◽  
Nicolas Durieux ◽  
Claude-Alain Maurage ◽  
Vincent Deramecourt ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Progressive Supranuclear Palsy ◽  
Cerebral Amyloid Angiopathy ◽  
Amyloid Angiopathy ◽  
Post Mortem ◽  
Resonance Imaging ◽  
Cerebral Amyloid ◽  
Magnetic Resonance Imaging Mri ◽  
Neuropathological Examination

Introduction and Purpose: Cerebral amyloid angiopathy (CAA) can be observed in patients with progressive supranuclear palsy (PSP), though to a lesser degree than in Alzheimer’s disease. The present post-mortem 7.0-tesla magnetic resonance imaging (MRI) evaluates whether CAA has an influence on the degree of hippocampal atrophy (HA) and on the incidence of associated micro-infarcts (HMIs) and cortical micro-bleeds (HMBs). Material and Methods: Eight brains with PSP-CAA were compared to 20 PSP brains without CAA. In addition to the neuropathological examination, the hippocampus was evaluated on the most representative coronal section with T2 and T2*-weighted MRI sequences. The average degree of HA was determined in both groups. The incidence of HMIs and HMBs was also compared as well as the frequency of cortical micro-infarcts (CoMIs) and cortical micro-bleeds (CoMBs) in the hemispheric neocortex. Results: The neuropathological examination showed a higher incidence of lacunar infarcts in the PSP-CAA brains compared to the PSP ones. With magnetic resonance imaging (MRI), the severity of HA and the incidence of HMIs and HMBs was similar between both groups. Additionally, the frequency of CoMIs and CoMBs in the neocortex was comparable. Conclusions: The association of CAA in PSP brains has no influence on the degree of HA and on the incidence of the small cerebrovascular lesions in the hippocampus as well as in the neocortex.

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