[Focal subarachnoid hemorrhage and cerebral amyloid angiopathy: a non-fortuitous association].
BACKGROUND
Cerebral amyloid angiopathy is a degenerative angiopathy due to amyloid deposits in the walls of the meningeal and cortical vessels. It is considered as a major cause of cerebral hemorrhage to the elderly. It was recently demonstrated that the association of focal meningeal bleedings and cerebral hemorrhage is very suggestive of cerebral amyloid angiopathy. In contrast, the links between subarachnoid hemorrhage and amyloid angiopathy are less well-known.


METHODS
We report nine cases of cerebral amyloid angiopathy. The clinical presentation was variable, but all had at least one inaugural meningeal bleeding. As cortico-meningeal biopsies were not performed the Boston criteria were used to establish the diagnosis.


CONCLUSIONS
Cerebral amyloid angiopathy is an underestimated cause of subarachnoid hemorrhage. Our observations show that this diagnosis should be evoked when focal meningeal bleeding occurs without head trauma or when focal subarachnoid hemorrhage is followed by a subcortical hematoma in an elderly subject.
Brunot
S
S
Service de neurologie, hôpital Général, CHU de Dijon, 3, rue du Faubourg-Raines, 21033 Dijon cedex, France. sandrinebrunot@hotmail.com
Fromont
A
A
Ricolfi
F
F
Moreau
T
T
Giroud
M
M
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000473:pathology; D005260:Female; D006486:Hemosiderosis / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008578:Meninges / Q000473:pathology; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000473:pathology; D014057:Tomography, X-Ray Computed