title: Cerebral vasculitis associated with amyloid angiopathy: case report.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Oita University School of Medicine, Yufu, Oita, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Morishige
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Abe
authors.forename: Tohru
authors.initials: T
authors.lastname: Kamida
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Hikawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Fujiki
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Toshiro
authors.initials: T
authors.lastname: Okazaki
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kimura
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kumamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Yamada
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kawano
mesh_terms: 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
chemical_list: D000893:Anti-Inflammatory Agents; D011241:Prednisone