Cerebral amyloid angiopathy CAA , is a form of angiopathy in which amyloid beta peptide deposits in the walls of small to medium blood vessels of the central nervous system and meninges. The amyloid material is only found in the brain and as such the disease is not related to other forms of amyloidosis. Since this can be caused by the same amyloid protein that is associated with Alzheimer's dementia, brain bleeds  are more common in people who have a diagnosis of Alzheimer's disease. However, they can also occur in those who have no history of dementia. The bleeding within the brain is usually confined to a particular lobe  and this is slightly different compared to brain bleeds which occur as a consequence of high blood pressure hypertension - a more common cause of a hemorrhagic stroke or bleeding in the brain.
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The resultant vascular fragility tends to manifest in normotensive elderly patients as lobar intracerebral hemorrhage. It is, along with Alzheimer disease , a common cerebral amyloid deposition disease. Importantly it is usually not associated with systemic amyloidoses. Familial cerebral amyloid angiopathy describes a group of very rare disorders that are usually encountered as autosomal dominant conditions 14, Many of these disorders are only isolated to only a few families and they mainly differ from spontaneous CAA in an earlier age of onset, typically in middle to late middle age 14, Furthermore, they may also be part of multi-system or other central nervous system genetic disorders 14, These TFNS are classically described as recurrent, stereotyped, spreading paraesthesias lasting several minutes but there is a wide spectrum of presentations encompassing both positive spreading paraesthesia or visual symptoms and negative paresis, aphasia or dysphagia phenomenology 17, These symptoms are most prominent with the convexity subarachnoid hemorrhage is localized to the central sulcus 16 , which is in close proximity to the primary motor and sensory cortices This is associated with fibrinoid degeneration with separation of the tunica media and tunica intima, and microaneurysm formation 1.
It and stains with Congo red yielding classic apple green birefringence when viewed with polarized light 3, When staining with thioflavin T and illuminated with ultraviolet light, the deposits emit bright green fluorescence Additionally, the Edinburgh criteria for lobar intracerebral hemorrhage associated with cerebral amyloid angiopathy can be utilized, especially for patients with a lobar intracerebral hemorrhage without an MRI There is currently as of April no disease-modifying treatment available Additionally, there are no guidelines regarding use of antiplatelet, anticoagulant, or thrombolytic drugs in patients with CAA, all medications which have been shown to increase the risk of disabling hemorrhage in this patient group Radiological differential diagnosis, particularly of cerebral microhemorrhages , includes:.
Neurodegenerative diseases are legion and their classification just as protean. A useful approach is to divide them according to underlying pathological process, although even using this schema, there is much overlap and thus resulting confusion.
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Please use another browser until we can get it fixed. On this page:. Quiz questions. Cerebral amyloid angiopathy presenting as nonhemorrhagic diffuse encephalopathy: neuropathologic and neuroradiologic manifestations in one case. Related Radiopaedia articles Neurodegenerative diseases Neurodegenerative diseases are legion and their classification just as protean.
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Figure 1: histology with Congo red stain Figure 1: histology with Congo red stain. Case 1 Case 1. Figure 2: histology with immunohistochemistry Figure 2: histology with immunohistochemistry. Case 3: with lobar hemorrhage Case 3: with lobar hemorrhage. Case 4 Case 4. Case 5 Case 5. Case 6: with lobar hemorrhage Case 6: with lobar hemorrhage.
Case 7: with multiple lobar hemorrhages Case 7: with multiple lobar hemorrhages. Case 8: with lobar hemorrhage Case 8: with lobar hemorrhage.
Case 9 Case 9. Case 10 Case Case 11 Case Case with inflammation Case with inflammation. Case with lobar hemorrhage Case with lobar hemorrhage. Case 15 Case Case familial British dementia Case familial British dementia. Case 18 Case Imaging differential diagnosis. Chronic hypertensive encephalopathy Chronic hypertensive encephalopathy.
Multiple cavernoma syndrome Multiple cavernoma syndrome. Diffuse axonal injury Diffuse axonal injury. Radiotherapy induced microhemorrhages Radiotherapy induced microhemorrhages.
Cerebral fat embolism Cerebral fat embolism. Neurocysticercosis Neurocysticercosis. Loading more images Close Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Loading Stack - 0 images remaining. By System:. Patient Cases. Contact Us.
Cerebral amyloid angiopathy
CAA irrupts as a intracranial hemorrhage, which can be a cerebral hematoma or multifocal microhemorrhages. There is evidence that uremic environment and glomerular filtration rate decline in patients with chronic kidney disease, aggravate cognitive functions and are related to microhemorrhages occurrence. In this regard, it is interesting the case of an 82 years old patient with chronic kidney disease and hemodialysis for four years, who was evaluated due to a 48 hours disorientation state. His antecedents included memory impairment for nine years and an episode of multiple microangiopathic infarcts eight years ago.
Cerebral amyloid angiopathy: a cross-sectional study in a single center in Northeastern Brazil. Until today, the prevalence of CAA is unknown in our region. This study aims to analyze the prevalence of this entity in a specific elderly population in a tertiary hospital in Northeastern Brazil. One hundred and seventy-four patients were enrolled, of whom were women