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Published on: March 7, 2019
Cerebral amyloid angiopathy with focal presentation-about 3 cases
Antoine Garnier-Crussard1,2, Amélie Taki3,4, Marc Bonnefoy3,4
1Institut du Vieillissement I-Vie, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France. antoine.garnier-crussard@chu-lyon.fr.
Insights
Cerebral amyloid angiopathy (CAA), a stroke-related condition, was diagnosed in Alzheimer's patients using advanced MRI. This focal form of CAA may offer insights into both diseases.
Area of Science:
- Neurology
- Neuroradiology
- Cerebrovascular Diseases
Background:
- Cerebral amyloid angiopathy (CAA) is a prevalent cerebrovascular disease linked to strokes and cognitive decline.
- Diagnosis relies on imaging criteria, with susceptibility-weighted imaging (SWI) enhancing detection of microbleeds (CMB), a hallmark of CAA.
Observation:
- Three Alzheimer's disease patients with a focal form of probable CAA were diagnosed using SWI MRI sequences.
- SWI imaging improves the sensitivity for detecting hemosiderin deposition and CMB, crucial for CAA diagnosis.
Findings:
- SWI sequences enabled the identification of a focal cerebral amyloid angiopathy in Alzheimer's patients.
- This imaging technique is vital for diagnosing CAA, especially in its less disseminated forms.
Implications:
- Focal CAA warrants increased clinical attention and may provide key insights into the pathogenesis of both Alzheimer's disease and CAA.
- Understanding focal CAA could advance research into neurodegenerative and cerebrovascular disease mechanisms.
Abstract:
Cerebral amyloid angiopathy (CAA) is a common cerebrovascular disease involved in ischemic and hemorrhagic strokes, and its progression is correlated to cognitive decline. In vivo diagnosis of CAA is guided by the modified Boston criteria, with the presence of multiple intracerebral hemorrhage or cerebral microbleeds (CMB), or single hemorrhage and cortical superficial siderosis. The diagnosis of CAA is highly dependent on the quality of imaging and the advent of susceptibility-weighted imaging (SWI) sequences has improved sensitivity of MRI to detect hemosiderin deposition and CMB, hallmarks of CAA. We report here 3 clinical cases of patients with Alzheimer's disease and a focal form (i.e., not disseminated) of probable CAA, diagnosed with SWI sequences. Focal CAA may require closer attention and could offer keys in the understanding of both Alzheimer's disease and CAA pathogenesis.
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