Three elderly patients with, respectively: mild cognitive impairment, severe and progressive neurologic involvement, and focal neurologic deficit, were observed. MRI showed multiple areas of white matter edema, at times partially involving the cortex, in the first two patients, and a single area in the third. Treatment with steroids determined the disappearance of the lesions and clinical amelioration. The key to the diagnosis of cerebral amyloid angiopathy-related inflammation (CAA-ri) was the demonstration, with appropriate MRI sequences, of microbleeds consistent with cerebral amyloid angiopathy (CAA). This diagnosis was supported by genetic analysis of APOE with demonstration of ε4/ε4 genotype, found in about 80% of CAA patients who develop inflammatory changes. In the appropriate clinical setting, MRI demonstration of microbleeds supported by results of genetic analysis of APOE may strongly support the diagnosis of CAA-ri thus avoiding cerebral biopsy.

Cerebral amyloid angiopathy-related inflammation: an emerging disease / M. Savoiardo, A. Erbetta, J.C. Di Francesco, M. Brioschi, V. Silani, A. Falini, G. Storchi, L. Brighina, C. Ferrarese, N. Ticozzi, S. Messina, F. Girotti. - In: THE NEURORADIOLOGY JOURNAL. - ISSN 1971-4009. - 24:2(2011 May 15), pp. 253-257. [10.1177/197140091102400214]

Cerebral amyloid angiopathy-related inflammation: an emerging disease

V. Silani;N. Ticozzi;
2011

Abstract

Three elderly patients with, respectively: mild cognitive impairment, severe and progressive neurologic involvement, and focal neurologic deficit, were observed. MRI showed multiple areas of white matter edema, at times partially involving the cortex, in the first two patients, and a single area in the third. Treatment with steroids determined the disappearance of the lesions and clinical amelioration. The key to the diagnosis of cerebral amyloid angiopathy-related inflammation (CAA-ri) was the demonstration, with appropriate MRI sequences, of microbleeds consistent with cerebral amyloid angiopathy (CAA). This diagnosis was supported by genetic analysis of APOE with demonstration of ε4/ε4 genotype, found in about 80% of CAA patients who develop inflammatory changes. In the appropriate clinical setting, MRI demonstration of microbleeds supported by results of genetic analysis of APOE may strongly support the diagnosis of CAA-ri thus avoiding cerebral biopsy.
Cerebral amyloid angiopathy; Edema; Inflammation; Microhemorrhages; MRI
Settore MED/26 - Neurologia
Settore MED/37 - Neuroradiologia
15-mag-2011
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/243811
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