Clinical diagnosis and successful treatment of inflammatory cerebral amyloid angiopathy

Richard A. Bernstein, Michael Gibbs, H. Hunt Batjer

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Introduction: Cerebral amyloid angiopathy is a major cause of lobar hemorrhage in older adults, and of microvascular ischemic disease. The rarest form of this disease is an inflammatory form causing seizures. It is important to recognize because the patients usually respond to a brief course of immunosuppression. Methods: Case report. Results: A 66-year-old man developed gradual cognitive decline, insidiously increasing headaches, and then had a likely seizure. MRI showed diffuse white matter edema, and innumerable superficial microhemorrhages characteristic of amyloid angiopathy. He was empirically treated with oral prednisone and an anticonvulsant. His symptoms improved and the white matter edema resolved over several months. ApoE genotype was 4/4, which is commonly found in inflammatory amyloid angiopathy. Conclusions: Inflammatory cerebral amyloid angiopathy can be clinically diagnosed and treated without brain biopsy. Clinical diagnosis is important because of the good response to a brief course of steroids in most cases.

Original languageEnglish (US)
Pages (from-to)453-455
Number of pages3
JournalNeurocritical Care
Volume14
Issue number3
DOIs
StatePublished - Jun 1 2011

Keywords

  • Amyloid-related inflammation
  • Cerebral amyloid angiopathy
  • Leukoencephalopathy
  • Lobar hemorrhage
  • Microhemorrhages
  • Seizures

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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