Stroke-like episodes heralding a reversible encephalopathy: Microbleeds as the key to the diagnosis of cerebral amyloid angiopathy-related inflammation-A case report and literature review

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Cerebral amyloid angiopathy (CAA) is a common, often asymptomatic disease. Lobar intracerebral hemorrhage is the most frequent manifestation of CAA. Nevertheless, presentation of CAA with subacute cognitive decline, seizures, or headache with concomitant hyperintensities on T2-weighted magnetic resonance imaging (MRI) sequences and neuropathologic evidence of inflammation has been described. This disorder is known as CAA-related inflammation (CAA-ri). Methods: Description of a stroke-like presentation of CAA-ri and systematic review of case reports and case series of CAA-ri. Results: A 75-year-old woman with a history of atrial fibrillation, and a transient episode of aphasia 2 days before, presented in the emergency room with sudden onset aphasia. Brain computed tomography disclosed a left temporal hypodensity. A diagnosis of probable stroke was given. During the following days, there was a progressive clinical deterioration. MRI revealed coalescent edematous white matter lesion, hyperintense on T2-weighted sequences, and multiple lobar microbleeds on T2{*}-weighted sequences. A diagnosis of CAA-ri was considered, and the patient was started on steroids with clinical and imaging improvement. From our systematic review, microbleeds were present in almost 90\% of patients with CAA-ri. Conclusions: Imaging findings associated with CAA-ri allow the early diagnosis and treatment of this potentially reversible disorder. Aside from the most common subacute presentations, CAA-ri can have a stroke-like presentation and be a stroke mimic. (C) 2015 by National Stroke Association}
Original languageEnglish
Pages (from-to)245-250
Number of pages5
JournalJournal Of Stroke & Cerebrovascular Diseases
Volume24
Issue number9
DOIs
Publication statusPublished - Sep 2015

Keywords

  • Neurosciences
  • Peripheral Vascular Disease

Fingerprint Dive into the research topics of 'Stroke-like episodes heralding a reversible encephalopathy: Microbleeds as the key to the diagnosis of cerebral amyloid angiopathy-related inflammation-A case report and literature review'. Together they form a unique fingerprint.

  • Cite this