Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (4): 119-122.doi: 10.6040/j.issn.1671-7554.0.2021.1104

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A case report of misdiagnosed cerebral amyloid angiopathy-related inflammation and literature review

SONG Luoqing, ZHOU Guoyu, YE Xiang, LU Mei, ZHAO Xinjing   

  1. Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-04-22

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Abstract: Objective To analyze the clinical manifestations and imaging features of a patient with misdiagnosed cerebral amyloid angiopathy-related inflammation(CAA-RI)in order to improve clinicians understanding of this disease. Methods The clinical data of a patient with CAA-RI were collected and analyzed, and relevant literature was reviewed. Results The patient was a 66-year-old female, admitted due to episodic loss of consciousness accompanied by convulsions for 9 years. Before admission, the patients memory gradually declined for 4 months. Physical examination showed decrease in recent memory, calculation ability and judgment. Brain imaging showed multiple old bleeding signals and local enhancement in the left cerebral hemisphere, multiple ischemic lesions or inflammatory changes in the left side of brain and stratified necrosis of the left occipital cortex. Mini Mental State Examination score was 14. Conclusion CAA-RI has various clinical manifestations. If a middle-aged or elderly patient has cognition impairment, seizure, headache or other neurologic deficits, imaging examination should be conducted. Especially when MRI shows asymmetric white matter hypersignal with multiple cerebral microbleeds, clinicians should be on alert for CAA-RI.

Key words: Cerebral amyloid angiopathy-related inflammation, Symptomatic epilepsy, Cognitive impairment

CLC Number: 

  • R743.9
[1] Bogner S, Bernreuther C, Matschke J, et al. Immune activation in amyloid-β-related angiitis correlates with decreased parenchymal amyloid-β plaque load [J]. Neurodegener Dis, 2014, 13(1): 38-44.
[2] Sakai K, Hayashi S, Sanpei K, et al. Multiple cerebral infarcts with a few vasculitic lesions in the chronic stage of cerebral amyloid angiopathy-related inflammation [J]. Neuropathology, 2012, 32(5): 551-556.
[3] Chu S, Xu F, Su Y, et al. Cerebral amyloid angiopathy(CAA)-related inflammation: comparison of inflammatory CAA and amyloid-β-related angiitis [J]. J Alzheimers Dis, 2016, 51(2): 525-532.
[4] Eng JA, Frosch MP, Choi K, et al. Clinical manifestations of cerebral amyloid angiopathy-related inflammation [J]. Ann Neurol, 2004, 55(2): 250-256.
[5] Wu JJ, Yao M, Ni J. Cerebral amyloid angiopathy-related inflammation: current status and future implications [J]. Chin Med J(Engl), 2021, 134(6): 646-654.
[6] Bravo Gá, Cirera LS, Torrentà LR. Clinical and radiological features of cerebral amyloid angiopathy-related inflammation [J]. Neurol Sci, 2021, 42(12):5353-5358.
[7] Kusakabe K, Inoue A, Matsumoto S, et al. Cerebral amyloid angiopathy-related inflammation with epilepsy mimicking a presentation of brain tumor: a case report and review of the literature [J]. Int J Surg Case Rep, 2018, 48: 95-100. doi: 10.1016/j.ijscr.2018.05.016.
[8] Yamashita Y, Hatano T, Ogawa T, et al. Steroid-responsive parkinsonism caused by cerebral amyloid angiopathy-related inflammation [J]. Mov Disord Clin Pract, 2020, 7(3): 329-331.
[9] Poli L, De Giuli V, Piazza F, et al. A challenging diagnosis of reversible “vascular” dementia: cerebral amyloid angiopathy-related inflammation [J]. J Neuroimmunol, 2020, 338: 577109. doi:10.1016/j.jneuroim.2019.577109.
[10] Corovic A, Kelly S, Markus HS. Cerebral amyloid angiopathy associated with inflammation: a systematic review of clinical and imaging features and outcome [J]. Int J Stroke, 2018, 13(3): 257-267.
[11] Regenhardt RW, Thon JM, Das AS, et al. Association between immunosuppressive treatment and outcomes of cerebral amyloid angiopathy-related inflammation [J]. JAMA Neurol, 2020, 77(10): 1261-1269.
[12] Chung KK, Anderson NE, Hutchinson D, et al. Cerebral amyloid angiopathy related inflammation: three case reports and a review [J]. J Neurol Neurosurg Psychiatry, 2011, 82(1): 20-26.
[13] Carmona-Iragui M, Videla L, Lleó A, et al. Down syndrome, Alzheimer disease, and cerebral amyloid angiopathy: The complex triangle of brain amyloidosis [J]. Dev Neurobiol, 2019, 79(7): 716-737.
[14] Auriel E, Charidimou A, Gurol ME, et al. Validation of clinicoradiological criteria for the diagnosis of cerebral amyloid angiopathy-related inflammation [J]. JAMA Neurol, 2016, 73(2): 197-202.
[15] 张文浩, 刘冉, 黄一宁. 脑淀粉样血管病相关炎症研究进展[J]. 中国现代神经疾病杂志, 2020, 20(9): 760-765. ZHANG Wenhao, LIU Ran, HUANG Yining. Research progress of cerebral amyloid angiopathy associated with inflammation [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2020, 20(9): 760-765.
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