Clinical case of early diagnosis of inflammatory form of cerebral amyloid angiopathy

Cover Page

Cite item

Full Text

Abstract

There was presented a clinical case of early recognition of inflammatory form of cerebral amyloid angiopathy in patient with severe diffuse headache, slightly responding to analgetics, and focal signs of pyramidal and cerebellar involvement. Clinical and radiological data were sufficient to make diagnosis of probable inflammatory form of cerebral amyloid angiopathy. Pulse-therapy with methylprednisolone was performed, followed by clinical and MRI data improvement. After 4 month relapse the cephalgia took place again due to viral infection. Pulse-therapy with corticosteroids was repeated with clinical improvement.

 

About the authors

Elena G. Klocheva

North-Western State Medical University named after I.I. Mechnikov

Email: klocheva@mail.ru

доктор медицинских наук профессор кафедры неврологии им. акад. С.Н. Давиденкова

Russian Federation, 195067, St. Petersburg, Piskarevsky pr., 47, building 12

Vitalij V. Goldobin

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: vgoldobin@inbox.ru

д.м.н. доцент кафедры неврологии им. акад. С.Н. Давиденкова

Russian Federation, 195067, St. Petersburg, Piskarevsky pr., 47, building 12

Nataliya  M. Tertyshnaya

North-Western State Medical University named after I.I. Mechnikov

Email: nataliyatertishnaia@gmail.com

аспирант кафедры неврологии им. акад. С.Н. Давиденкова

Russian Federation, 195067, St. Petersburg, Piskarevsky pr., 47, building 12,

Maryna Osipova

North-Western State Medical University named after I.I. Mechnikov

Email: mebsen@mail.ru

аспирант кафедры неврологии им. акад. С.Н. Давиденкова

Russian Federation, 195067, St. Petersburg, Piskarevsky pr., 47, building 12

References

  1. Макотрова Т.А., Левин О.С., Араблинский А.В. Церебральная амилоидная ангиопатия. Ж. неврол. и психиатрии. 2014; 6 (2): 87–93. [Makotrova T.A., Levin O.S., Arablinskiy A.V. Cerebral amyloid angiopathy. Zhurnal nevrologii i psychiatrii. 2014; 6 (2): 87–93. (In Russ.)]
  2. Новосадова О.А., Григорьева В.Н. Церебральная амилоидная ангиопатия и гипертензивная церебральная микроангиопатия. Дифференциальный диагноз. Неврол. вестн. им. В.М. Бехтерева. 2019; LI (2): 72–79. [Novosadova O.A., Grigorjeva V.N. Cerebal amyloid angiopathy and hypertensive cerebral microangiopathy. Differential diagnosis. Nevrologicheskiy vestnik im. V.M. Bekhtereva. 2019; LI (2): 72–79. (In Russ.)]
  3. Vonsattel J.P., Myers R.H., Hedley-Whyte E.T. et al. Cerebral amyloid angiopathy without and with cerebral hemorrhages: a comparative histological study. Ann. Neurol. 1991; 30: 637–649.
  4. Coria F., Rubio I. Cerebral amyloid angiopathies. Neuropathol. Appl. Neurobiol. 1996; 22: 216e27.
  5. Yamada M. Predicting cerebral amyloid angiopathy-related intracerebralhemorrhages and other cerebrovascular disorders in Alzheimer’s disease. Front. Neurol. Stroke. 2012; 3: 1–7. doi: 10.3389/fneur.2012.00064.
  6. Chung K.K., Anderson N.E., Hutchinson D. et al. Cerebral amyloid angiopathy related inflammation: three case reports and a review. J. Neurol. Neurosurg. Psychiatry. 2011; 82 (1): 20–26. doi: 10.1136/jnnp.2009.204180.
  7. Scolding N.J., Joseph F., Kirby P.A. et al. Abeta-related angiitis: primary angiitis of the central nervous system associated with cerebral amyloid angiopathy. Brain. 2005; 128: 500–515.
  8. Melzer N., Harder A., Gross C.C. et al. CD41 T cells predominate in cerebrospinal fluid and leptomeningeal and parenchymal infiltrates in cerebral amyloid beta-related angiitis. Arch. Neurol. 2012; 69: 773–777. doi: 10.1001/archneurol.2011.2441.
  9. Eng J.A., Frosch M.P., Choi K. et al. Clinical manifestations of cerebral amyloid angiopathy-related inflammation. Ann. Neurol. 2004; 55 (2): 250–256. doi: 10.1002/ana.10810.
  10. DiFrancesco J.C., Brioschi M., Brighina L. et al. Anti-Abeta autoantibodies in the CSF of a patient with CAA-related inflammation: a case report. Neurology. 2011; 76 (9): 842–844. doi: 10.1212/WNL.0b013e31820e773c.
  11. Martucci M., Sarria S., Toledo M. et al. Cerebral amyloid angiopathy-related inflammation: imaging findings and clinical outcome. Neuroradiology. 2014; 56 (4): 283–289. doi: 10.1007/s00234-014-1330-6.
  12. Auriel E., Charidimou A., Gurol M.E. et. al. Validation of clinicoradiological criteria for the diagnosis of cerebral amyloid angiopathy-related inflammation. JAMA Neurol. 2016; 73 (2): 197–202. doi: 10.1001/jamaneurol.2015.4078.
  13. Kirshner H.S., Bradshaw M. The inflammatory form of cerebral amyloid angiopathy or “Cerebral Amyloid Angiopathy-Related Inflammation” (CAARI). Curr. Neurol. Neurosci. Rep. 2015; 15: 54–60. doi: 10.1007/s11910-015-0572-y.
  14. Piazza F., Greenberg S.M., Savoiardo M. et al. Anti-amyloid beta autoantibodies in cerebral amyloid angiopathy-related inflammation: implications for amyloid-modifying therapies. Ann. Neurol. 2013; 73 (4): 449–458. doi: 10.1002/ana.23857.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. The results of magnetic resonance imaging of the brain of the patient during the first visit to the clinic. The results of the study in the modes SWI (A, B) and FLAIR (C) are presented. Arrows indicate foci of multiple microbleeds and asymmetric zones of leukoaraiosis

Download (167KB)
Indexing metadata
3. Fig. 2. The results of magnetic resonance imaging of the brain during repeated visits to the clinic. The results of the study in the modes SWI (A) and FLAIR (B) are presented. Arrows indicate foci of multiple microbleeds and asymmetric zones of leukoaraiosis

Download (116KB)
Indexing metadata

Copyright (c) 2020 Klocheva E.G., Goldobin V.V., Tertyshnaya N.M., Osipova M.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies