Acute progression of cerebral amyloid angiopathy-related inflammation diagnosed by biopsy in an elderly patient: A case report.

Autor:	Kuwahara K; Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake.; Department of Neurosurgery, Nishichita General Hospital, Tokai., Moriya S; Department of Neurosurgery, Nishichita General Hospital, Tokai., Nakahara I; Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake., Kumai T; Department of Neurosurgery, Fujita Health University School of Medicine, Toyoake., Maeda S; Department of Neurosurgery, Fujita Health University School of Medicine, Toyoake., Nishiyama Y; Department of Neurosurgery, Fujita Health University School of Medicine, Toyoake., Watanabe M; Department of Pathology, Nishichita General Hospital, Tokai, Japan., Mizoguchi Y; Department of Pathology, Nishichita General Hospital, Tokai, Japan., Hirose Y; Department of Neurosurgery, Fujita Health University School of Medicine, Toyoake.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2022 Jun 23; Vol. 13, pp. 268. Date of Electronic Publication: 2022 Jun 23 (Print Publication: 2022).
DOI:	10.25259/SNI_195_2022
Abstrakt:	Background: Cerebral amyloid angiopathy-related inflammation (CAA-I) presents with slowly progressive nonspecific neurological symptoms, such as headache, cognitive function disorder, and seizures. Pathologically, the deposition of amyloid-β proteins at the cortical vascular wall is a characteristic and definitive finding. Differential diagnoses include infectious encephalitis, neurosarcoidosis, primary central nervous system lymphoma, and glioma. Here, we report a case of CAA-I showing acute progression, suggesting a glioma without enhancement, in which a radiological diagnosis was difficult using standard magnetic resonance imaging. Case Description: An 80-year-old woman was admitted due to transient abnormal behavior. Her initial imaging findings were similar to those of a glioma. She presented with rapid progression of the left hemiplegia and disturbance of consciousness for 6 days after admission and underwent emergent biopsy with a targeted small craniotomy under general anesthesia despite her old age. Intraoperative macroscopic findings followed by a pathological study revealed CAA-I as the definitive diagnosis. Steroid pulse therapy with methylprednisolone followed by oral prednisolone markedly improved both the clinical symptoms and imaging findings. Conclusion: Differential diagnosis between CAA-I and nonenhancing gliomas may be difficult using standard imaging studies in cases presenting with acute progression. A pathological diagnosis under minimally invasive small craniotomy may be an option, even for elderly patients. Competing Interests: There are no conflicts of interest. (Copyright: © 2022 Surgical Neurology International.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu