Amyloid Angiopathy: MRI
64 year old male with a known chronic kidney
dysfunction & myocardial ischaemia
presence with altered sensorium. The MRI brain shows extensive parenchymal bleeds of varying sizes
in the entire cerebral, cerebellar parenchyma, basal ganglia & brain stem with T1
hyperintensity and blooming on SW with atheromatous circle of Willis branches
with no extra axial or intraventricular
extension, possibly representing cerebral amyloid angiopathy. Case submitted by
Dr MGK Murthy, Mr Venkat and Mr Senthil
Teaching points :
Predominantly
seen in elderly, and results from beta-amyloid protein deposition in cortical,
subcortical or lepto meningeal vessels (in the media and adventitia of small
and medium sized vessels) .
CT
or MRI are the imaging modalities of the
choice.
Though
hereditary forms are known in the younger age group, sporadic age related form
is the commonest. Incidence increases with age reaching 75% of those older than 90 years. Not
associated with systemic amyloidosis.
Asymptomatic
to severe intracranial bleeds and TIAs are the usual presentations.
Boston
criteria specifies four categories – definite CAA, probable CAA (with
pathological evidence), probable CAA, and possible CAA. Petechial
haemorrhages (less than 5 mm) in size are usually asymptomatic.
From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.tele...
Source: Sumer's Radiology Site - Category: Radiologists Authors: Sumer Sethi Source Type: blogs
More News: Amyloidosis | Blogging | Brain | Men | Neurology | Radiologists | Radiology | Teaching | Universities & Medical Training | Urology & Nephrology