A Case of Amyloid Beta-Related Angiitis: Rare Inflammatory Vasculopathy of the Central Nervous System

Cerebral amyloid angiopathy (CAA) is associated with amyloid-beta deposition in cerebrovascular vessels, leading to spontaneous intracerebral hemorrhage (ICH). A rare manifestation, amyloid beta-related angiitis (ABRA), presents with symptoms including subacute progressive headaches, cognitive decline, and focal neurological deficits. This case report discusses a 78-year-old female patient with a history of hypertension who exhibited symptoms consistent with ABRA, including headaches and memory impairments. Diagnostic imaging revealed significant MRI findings of confluent hyperintensities and microhemorrhages, while a temporal brain biopsy confirmed granulomatous arteritis linked to amyloid angiopathy. Treatment with corticosteroids resulted in notable clinical improvement. This report underscores the importance of early diagnosis and intervention in ABRA, promoting the establishment of non-invasive diagnostic criteria to distinguish it from other CAA-related conditions, thereby potentially facilitating prompt treatment without the necessity for invasive procedures.