A case of cerebral amyloid angiopathy with reversible white matter lesions and multiple cerebral microbleeds
| Autor: | Toshihiko Ohashi, Tsuyoshi Uchiyama, Daisuke Takechi, Yasushi Hosoi, Takako Shimizu, Mari Yoshida, Yoshiro Otsuki |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Pathology
medicine.medical_specialty medicine.diagnostic_test business.industry Brain biopsy Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Hyperintensity White matter Cerebral Amyloid Angiopathy medicine.anatomical_structure Prednisolone medicine Humans Female Neurology (clinical) Cerebral amyloid angiopathy Vasculitis Occipital lobe business Cerebral Hemorrhage medicine.drug |
| Zdroj: | Rinsho Shinkeigaku. 52:90-95 |
| ISSN: | 1882-0654 0009-918X |
| DOI: | 10.5692/clinicalneurol.52.90 |
| Popis: | A 59-year-old woman presented with a 7-year history of headache. She showed no neurological abnormality. T(2) weighted magnetic resonance (MR) images showed a hyperintense signal in the white matter in the bilateral parieto-occipital lobe without abnormal enhancement. A small amount of prednisolone was administered for rheumatoid arthritis. After prednisolone was discontinued, the T(2) weighted images showed an expansion of the hyperintense signal lesions seen in the white matter, and T(2) weighted image showed multiple foci of petechial bleeding in the cortex and subcortex of the bilateral occipital lobe. A brain biopsy specimen from the right occipital lobe revealed deposition of amyloid in the subarachnoidal and cortical vessel walls and transmural infiltration of a few lymphocytes, eosinophils, and giant histiocytes. Subsequently the patient was diagnosed with central nervous system vasculitis associated with cerebral amyloid angiopathy (CAA). After 5 months, the T(2) weighted images showed a remarkable regression of the hyperintense signal lesions in the white matter of the bilateral parieto-occipital lobe without the administration of any maintenance immunosuppressive agents. However, T(2) weighted image showed an increase of multiple cortico-subcortical foci of petechial bleeding. Her headache did not improve during the illness. Thus, we should consider the diagnosis of CAA when patients present with reversible white matter lesions and multiple cerebral microbleeds simultaneously. |
| Databáze: | OpenAIRE |
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