| Popis: |
Objective To study the clinical features, auxiliary examination, diagnosis and treatment, and prognosis of cerebral amyloid angiopathy-related inflammation (CAA-ri). Methods and Results Two elderly female cases with CAA-ri during February 2017 to February 2018 in our hospital were reported. Both of them manifested with cognitive impairment, gait abnormality and decreased daily life ability. Lumbar puncture of 2 cases showed the pressure of cerebrospinal fluid (CSF) was normal, white blood cell (WBC) count was generally normal and protein quantification was increased (988 and 975 mg/L). One case presented decreased CSF amyloid-β protein 40 (A β40) and 42 (A β42), and the other one had decreased Aβ42 . One case was apolipoprotein E (ApoE) ε3/ε3, and the other was ε3/ε4. Brain MRI showed long T1 and long T2 abnormal signals with flaky fusion, and susceptibility-weighted imaging (SWI) showed multiple cortical and subcortical microhemorrhage. They were diagnosed as CAA-ri, and the symptoms were obviously improved after methylprednisolone implosive sequential therapy. Conclusions In addition to cognitive impairment, gait abnormality can also be the main clinical manifestation of CAA-ri. Typical imaging changes are white matter hyperintensity on T2WI and FLAIR fusion sequences, with multiple cortical and subcortical hemorrhagic lesions on SWI. Once the typical clinical and imaging changes meet the diagnostic criteria, the diagnosis of CAA-ri can be made without biopsy. Immunotherapy is effective for most patients. DOI: 10.3969/j.issn.1672-6731.2019.01.011 |
