Cerebral vasculitis associated with amyloid angiopathy: case report.
A 78-year-old female presented with coexisting primary angiitis of the central nervous system (CNS) and cerebral amyloid angiopathy (CAA) manifesting as motor aphasia caused by a left frontal lobe lesion. Magnetic resonance imaging revealed an enhanced lesion with moderate surrounding edema.Technetium-99m propylene amine oxime single-photon emission computed tomography showed decreased cerebral blood flow (CBF) in the lesions, and high serum soluble-interleukin-2 level was detected, suggesting intravascular lymphoma of the CNS. Cerebral biopsy revealed CAA with secondary florid vasculitic appearance. The CBF and neurological symptoms, such as aphasia and dementia, recovered following steroid treatment. Cerebral vasculitis associated with CAA should be included in the differential diagnosis of an unusually enhanced lesion, because timely diagnosis and aggressive treatment are critical to successful recovery in such elderly patients.
Morishige
Masaki
M
Department of Neurosurgery, Oita University School of Medicine, Yufu, Oita, Japan.
Abe
Tatsuya
T
Kamida
Tohru
T
Hikawa
Takamitsu
T
Fujiki
Minoru
M
Kobayashi
Hidenori
H
Okazaki
Toshiro
T
Kimura
Noriyuki
N
Kumamoto
Toshihide
T
Yamada
Akira
A
Kawano
Yoshihisa
Y
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001039:Aphasia, Broca / Q000209:etiology / Q000473:pathology; D001932:Brain Neoplasms / Q000473:pathology*; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D003704:Dementia / Q000209:etiology / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008223:Lymphoma / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D011241:Prednisone / Q000627:therapeutic use; D011877:Radionuclide Imaging; D016896:Treatment Outcome; D020293:Vasculitis, Central Nervous System / Q000150:complications* / Q000188:drug therapy / Q000473:pathology
D000893:Anti-Inflammatory Agents; D011241:Prednisone