title: Pre-critical MRI findings of an Alzheimer's disease patient with pathologically proven cerebral amyloid angiopathy related lobar hemorrhage.
abstract: An 85-year-old woman with untreated hypertension was admitted with a disturbance of consciousness. On admission, brain CT revealed a lobar intracerebral hemorrhage with a midline shift. An intracranial hematoma was evacuated via a life-saving craniotomy. Definite pathological findings of amyloid-β deposition in the excised hematoma (strong in anti-amyloid β40 immunostain, but weak in anti- amyloid β42) indicated cerebral amyloid angiopathy (CAA). She had been diagnosed with Alzheimer's disease at a regional memory clinic one month before symptom onset based on MRI findings of medial temporal lobe atrophy as well as CAA-related features of multiple strictly lobar cerebral microbleeds in the occipital lobe, cortical superficial siderosis and >20 enlarged perivascular spaces in the centrum semiovale. This experience suggests that comprehensive interpretation of such CAA-related findings on MRI might help to improve the management of cardiovascular risk factors for Alzheimer's disease.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nonaka
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yakushiji
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Ide
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Hideo
authors.initials: H
authors.lastname: Hara
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging