Cerebral amyloid angiopathy-related inflammation: imaging findings and clinical outcome.
BACKGROUND
We aim to investigate the clinical onset, computed tomography (CT) and magnetic resonance (MR) imaging findings, and follow-up of patients with cerebral amyloid angiopathy (CAA)-related inflammation, an uncommon but clinically striking presentation of CAA.


METHODS
We retrospectively reviewed the clinical manifestations, CT/MR imaging findings, and outcome of ten consecutive patients with CAA-related inflammation. In each patient, a brain CT study was performed at hospital admission, and brain MR imaging was carried out 2 to 4 days later. Clinical and radiologic follow-up findings were evaluated in all patients.


RESULTS
The most common clinical onset was rapidly progressive cognitive decline, followed by focal neurological signs. Brain CT/MR showed unenhanced expansive subcortical lesions, corresponding to areas of vasogenic edema, associated with chronic lobar, cortical, or cortical-subcortical micro/macrohemorrhages. Clinical symptoms recovered in a few weeks under treatment in eight patients and spontaneously in the remaining two. MRI follow-up at 2 to 12 months after treatment showed resolution of the lesions. Three patients experienced symptomatic disease recurrence, with new lesions on CT/MR.


CONCLUSIONS
In the absence of histological data, early recognition of the clinical symptoms and typical radiologic features of CAA-related inflammation is essential to enable timely establishment of proper treatment.
Neuroradiology Unit, Radiology Department (IDI), Vall d´Hebrón University Hospital, Barcelona, Spain, matia.martucci@gmail.com.
Matia
M
Martucci
Silvana
S
Sarria
Manuel
M
Toledo
Pilar
P
Coscojuela
Carla
C
Vert
Sahyly
S
Siurana
Cristina
C
Auger
Alex
A
Rovira
D000368:Aged; D000369:Aged, 80 and over; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000175:diagnosis*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D004684:Leukoencephalitis, Acute Hemorrhagic / Q000175:diagnosis* / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*