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Spontaneous upper limb monoplegia secondary to probable cerebral amyloid angiopathy

Ahmed-Ramadan Sadek1, Nandita K Parmar, Norah-Hager Sadek

  • 1Wessex Neurological Centre, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO16 6YD, UK. a.sadek@soton.ac.uk.

International Journal of Emergency Medicine
|January 5, 2012
PubMed

Insights

Cerebral amyloid angiopathy, a condition causing amyloid buildup in brain vessels, can lead to intracerebral hemorrhage. This case highlights its varied presentations, even with isolated neurological deficits.

Area of Science:

  • Neurology
  • Pathology
  • Radiology

Background:

  • Cerebral amyloid angiopathy (CAA) involves amyloid deposition in cerebral vasculature.
  • This deposition increases the risk of primary intracerebral hemorrhage.
  • CAA is often an underdiagnosed cause of stroke-like symptoms.

Purpose of the Study:

  • To report an unusual case of cerebral amyloid angiopathy.
  • To illustrate the diverse clinical presentations of CAA.
  • To emphasize CAA as a differential diagnosis for intracerebral hemorrhage.

Main Methods:

  • Case report of a 77-year-old female patient.
  • Initial presentation with acute neurological deficits (hypoesthesia, monoplegia).
  • Diagnostic imaging including CT and MRI to identify hemorrhage and edema.

Main Results:

  • CT revealed an acute peripheral hematoma in the left perirolandic cortex.
  • MRI showed evidence of prior superficial hemorrhagic events.
  • Patient experienced recurrent episodes of aphasia and limb jerking, with associated edema on imaging.

Conclusions:

  • Cerebral amyloid angiopathy can present with isolated neurological deficits.
  • The varied manifestations underscore the importance of considering CAA in intracerebral hemorrhage cases.
  • Prompt diagnosis and management are crucial for patients with CAA-related events.

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