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Clinical Manifestations.

Takeshi Kawarabayashi1, Takumi Nakamura2, Shin Takatama3

  • 1Geriatrics Research Institute and Hospital, Maebashi, Japan.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

This study details a rare case of iatrogenic cerebral amyloid angiopathy (iCAA) in a 42-year-old man, 33 years after a cadaveric dura graft. The findings suggest vascular amyloid-beta (Aß40) transmission and potential prevention of further hemorrhages with corticosteroid therapy.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Pathology

Background:

  • Iatrogenic cerebral amyloid angiopathy (iCAA) is increasingly reported in young adults following cadaveric dural grafts or childhood neurosurgery.
  • Over 80 cases of iCAA exist, but details on amyloid-beta (Aß40) transmission remain insufficient.

Purpose of the Study:

  • To present a unique case of Aß iCAA with a 33-year clinical course after a cadaveric dural graft.
  • To investigate the transmission and propagation of Aß40 amyloid.

Main Methods:

  • Case presentation of a 42-year-old male with recurrent intracranial hemorrhages (ICHs) after childhood dural grafting (LYODURA).
  • Analysis of brain tissue showing Aß40 deposition in leptomeningeal vessels.
  • Cerebrospinal fluid (CSF) analysis and genetic testing (APP, PSEN-1/-2, APOE).
  • Follow-up imaging and clinical assessment after corticosteroid therapy.

Main Results:

  • The patient experienced multiple ICHs, with brain tissue revealing significant Aß40 deposition, consistent with iCAA.
  • No APP/PSEN mutations or APOE ε4 allele were found; CSF Aß42/Aß40 levels were decreased.
  • Corticosteroid therapy was initiated, and no further ICHs occurred during 2-year follow-up.

Conclusions:

  • This case strongly suggests vascular Aß40 transmission and propagation from LYODURA cadaveric dura.
  • Corticosteroid therapy may help prevent further iCAA-induced ICHs, though its efficacy in non-inflammatory iCAA requires further investigation.