CEREBRAL AMYLOID ANGIOPATHY

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CEREBRAL AMYLOID ANGIOPATHY

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Contents

Epidemiology

– MCC of recurrent ICH in elderly normotensive pts – Incidence rises after 70 yrs – Sporadic and familial forms (Iceland/Holland)

Pathogenesis

– Contractile elements of leptomeningeal and cortical arteries are replaced by non-contractile amyloid beta protein

Histology

– Amyloid deposits in media and adventitia of small and medium-sized arteries – Stain intensely with Congo red – Birefringence in polarized light

CAA1.gif CAA3.gif

Gross

– Subcortical or lobar – Predominantly in the occipital and parietal lobes – Multiplicity over time and location

CAA2.gif

Pre-ictus History

– TIA-like symptoms consisting of numbness, tingling or weakness involving the area where the hemorrhage will subsequently occur

Studies

– CT an MRI findings of multiple peripherally located hemorrhages of different ages

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