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[Cerebral amyloid angiopathy and recurrent cerebral hematoma. Clinicopathological study of a case]
P Fossas1, P Barrufet, J Andreu
1Unidad de Neurología, Hospital L'Aliança Mataronina, Mataró.
Cerebral amyloid angiopathy (CAA) is an almost constant finding in Alzheimer's disease and in Alzheimer type senile dementia (EA/DSTA) but it has also been described in association with other processes such as in age-related hereditary or non hereditary cerebral hemorrhage (CH) relapse. The case of a non hypertensive 78 year old women is presented. Over a period of 27 months the patient had 3 cerebral hemorrhages located in the left parietotemporal, caudate nucleus and right frontobasal and right parietotemporal lobes, all of which had cortico-subcortical topography and eruption of blood to the subarachnoid space. The fundamental finding in the neuropathological study was the CAA with massive involvement in the leptomeninges and cortex, less in cerebellum and nucleus of the base, occasional in white matter and absent in the brain stem trunk. Abundant senile plaques and figures of neurofibrillar degeneration were found. Granulovacuolar degeneration or Hyrano bodies were not observed. At the level of the main intracraneal arterial trunks only a small plaque of atheroma was observed in the left vertebral artery. The association of CAA and CH in the literature and their relation with EA/DSTA are revised.
Cerebral amyloid angiopathy (CAA) is an almost constant finding in Alzheimer's disease and in Alzheimer type senile dementia (EA/DSTA) but it has also been described in association with other processes such as in age-related hereditary or non hereditary cerebral hemorrhage (CH) relapse. The case of a non hypertensive 78 year old women is presented. Over a period of 27 months the patient had 3 cerebral hemorrhages located in the left parietotemporal, caudate nucleus and right frontobasal and right parietotemporal lobes, all of which had cortico-subcortical topography and eruption of blood to the subarachnoid space. The fundamental finding in the neuropathological study was the CAA with massive involvement in the leptomeninges and cortex, less in cerebellum and nucleus of the base, occasional in white matter and absent in the brain stem trunk. Abundant senile plaques and figures of neurofibrillar degeneration were found. Granulovacuolar degeneration or Hyrano bodies were not observed. At the level of the main intracraneal arterial trunks only a small plaque of atheroma was observed in the left vertebral artery. The association of CAA and CH in the literature and their relation with EA/DSTA are revised.