Case 232: Amyloid β-related Angiitis

Area of Science:

• Neurology
• Radiology

Background:

• A 78-year-old female presented with an unwitnessed fall and transient ischemic attack (TIA)-like symptoms.
• Medical history included memory impairment and a prior left posterior cerebral artery infarction.
• No history of infection, malignancy, or immunosuppression was reported.

Observation:

• Initial head computed tomography (CT) demonstrated vasogenic edema in the right temporal-parietal region.
• Laboratory tests showed elevated C-reactive protein (29 mg/L) and erythrocyte sedimentation rate (35 mm/hr).
• The patient experienced a generalized tonic-clonic seizure shortly after admission.

Findings:

• Magnetic resonance (MR) imaging of the brain was performed for further evaluation.
• The findings are suggestive of an underlying inflammatory or ischemic neurological process.
• The combination of symptoms and imaging findings warrants further investigation.

Implications:

• This case highlights the importance of comprehensive neuroimaging and laboratory work-up in elderly patients with neurological deficits and falls.
• Understanding the etiology of vasogenic edema in this context is crucial for appropriate management.
• Further investigation may reveal an underlying condition contributing to recurrent neurological events.