A case of inflammatory cerebral amyloid angiopathy with white matter lesions appearing after brain biopsy

Abstract A 77 year-old men developed a subacute-onset, rapidly progressive cognitive decline. After 6 months of evolution, he scored 6 on the Mini-Mental State Examination and had left hemiparesis and hemineglect. The patient died 11 months after the onset of cognitive symptoms. Brain MRI showed microhemorrhages on gradient-echo sequence and confluent areas of white matter hyperintensities on T2-weighted images. Brain biopsy revealed amyloid-b peptide deposition in vessel walls, some of them surrounded by micro-bleeds. In this case report, we discuss the role of cerebral amyloid angiopathy (CAA) in cognitive decline, due to structural lesions associated with hemorrhages and infarcts, white matter lesions and co-morbidity of Alzheimer's disease, as well as the most recently described amyloid angiopathy-related inflammation.

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A case of cerebral amyloid angiopathy with reversible white matter lesions and multiple cerebral microbleeds

Rinsho Shinkeigaku ◽

10.5692/clinicalneurol.52.90 ◽

2012 ◽

Vol 52 (2) ◽

pp. 90-95 ◽

Cited By ~ 1

Author(s):

Yasushi Hosoi ◽

Tsuyoshi Uchiyama ◽

Mari Yoshida ◽

Daisuke Takechi ◽

Takako Shimizu ◽

...

Keyword(s):

White Matter ◽

Cerebral Amyloid Angiopathy ◽

White Matter Lesions ◽

Cerebral Microbleeds ◽

Amyloid Angiopathy ◽

Cerebral Amyloid

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Cerebral amyloid angiopathy-related leukoencephalopathy: Successful steroid treatment for neurological deficits and subcortical white matter lesions partly involving the cortical gray matter

Neurology and Clinical Neuroscience ◽

10.1111/ncn3.101 ◽

2014 ◽

Vol 2 (4) ◽

pp. 119-121

Author(s):

Takenobu Murakami ◽

Julia Morimoto ◽

Akihiko Hoshi ◽

Setsu Nakatani-Enomoto ◽

Masahiro Ichikawa ◽

...

Keyword(s):

White Matter ◽

Cerebral Amyloid Angiopathy ◽

Gray Matter ◽

White Matter Lesions ◽

Subcortical White Matter ◽

Steroid Treatment ◽

Neurological Deficits ◽

Amyloid Angiopathy ◽

Cortical Gray Matter ◽

Cerebral Amyloid

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Cerebral Amyloid Angiopathy: Multiple neurolgic problems

Psychology and Mental Health Care ◽

10.31579/2637-8892/015 ◽

2017 ◽

Vol 1 (3) ◽

pp. 01-01

Author(s):

Paul Gilbert

Keyword(s):

White Matter ◽

Cerebral Amyloid Angiopathy ◽

Clinical Symptoms ◽

Brain Biopsy ◽

Acute Onset ◽

Amyloid Angiopathy ◽

Migraine Headaches ◽

Diffuse White Matter ◽

Cerebral Amyloid ◽

Intravenous Steroids

A 72-Year-old female with a history of migraine headaches presented with an acute onset of expressive aphasia, difficulty with memory and worsening of her headaches. An MRI of the brain was done which revealed diffuse white matter T2 hyperintensities (Figures 1). Due to worsening of the patient’s clinical symptoms a repeat MRI was performed four days later that revealed multiple micro-bleeds (Figure 2), as well as a lobar hemorrhage in left temporal lobe (Figure 2). An extensive workup including HIV testing, CSF examination for infectious etiology including protein 14-3-3 and demylineating disease was negative. Paraneoplastic and autoimmune workup was also non-diagnostic. A brain biopsy was performed due to the extensive white matter disease, which revealed Cerebral Amyloid Angiopathy (CAA) with focal granulomatous angiitis. The patient was treated with intravenous steroids with no significant improvement clinically. Two months after diagnosis, her disease course has remained static, without improvement or deterioration.

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