eMedicine Specialties > Neurology > Neuro-vascular Diseases

Cerebral Amyloid Angiopathy: Multimedia

Author: Ravi S Menon, MD, Clinical Fellow in Stroke Diagnostic and Therapeutics, National Institute of Health, National Institute of Neurological Disorders and Stroke
Coauthor(s): Jose G Merino, MD, Medical Director, Suburban Hospital Stroke Program; Vladimir C Hachinski, MD, MSc, DSc, FRCP(C), Professor, Departments of Medicine, Physiology, London Health Sciences Center, University of Western Ontario, Canada
Contributor Information and Disclosures

Updated: Aug 20, 2008

Multimedia

MRI Brain GRE 3.0 Tesla<BR>Top: Multiple scattere...Media file 1: MRI Brain GRE 3.0 Tesla
Top: Multiple scattered microbleeds in multiple vascular territories in patient with hyperhomocysteinemia and methylene-tetrahydrofolate reductase mutation.
Middle: Acute parenchymal hematoma with typical appearance of right occipital microbleed and left parietal chronic microhemorrhage.
Bottom: Microbleeds involving multiple lobes. Chronic hemorrhage in the left parietal lobe with typical slit-like appearance.
MRI Brain GRE 3.0 Tesla<BR>Top: Multiple scattere...

MRI Brain GRE 3.0 Tesla
Top: Multiple scattered microbleeds in multiple vascular territories in patient with hyperhomocysteinemia and methylene-tetrahydrofolate reductase mutation.
Middle: Acute parenchymal hematoma with typical appearance of right occipital microbleed and left parietal chronic microhemorrhage.
Bottom: Microbleeds involving multiple lobes. Chronic hemorrhage in the left parietal lobe with typical slit-like appearance.

More on Cerebral Amyloid Angiopathy

Overview: Cerebral Amyloid Angiopathy
Differential Diagnoses & Workup: Cerebral Amyloid Angiopathy
Treatment & Medication: Cerebral Amyloid Angiopathy
Follow-up: Cerebral Amyloid Angiopathy
Multimedia: Cerebral Amyloid Angiopathy
References

References

  1. Ellis RJ, Olichney JM, Thal LJ, Mirra SS, Morris JC, Beekly D, et al. Cerebral amyloid angiopathy in the brains of patients with Alzheimer's disease: the CERAD experience, Part XV. Neurology. Jun 1996;46(6):1592-6. [Medline].

  2. Oh U, Gupta R, Krakauer JW, et al. Reversible leukoencephalopathy associated with cerebral amyloid angiopathy. Neurology. Feb 10 2004;62(3):494-7. [Medline].

  3. Greenberg SM. Cerebral amyloid angiopathy: prospects for clinical diagnosis and treatment. Neurology. Sep 1998;51(3):690-4. [Medline].

  4. Yamashita T, Ando Y, Ueda M, Nakamura M, Okamoto S, Zeledon ME. Effect of liver transplantation on transthyretin Tyr114Cys-related cerebral amyloid angiopathy. Neurology. Jan 8 2008;70(2):123-8. [Medline].

  5. Izumihara A, Ishihara T, Iwamoto N, et al. Postoperative outcome of 37 patients with lobar intracerebral hemorrhage related to cerebral amyloid angiopathy. Stroke. Jan 1999;30(1):29-33. [Medline].

  6. Blitstein MK, Tung GA. MRI of cerebral microhemorrhages. AJR Am J Roentgenol. Sep 2007;189(3):720-5. [Medline].

  7. Chalela JA, Kang DW, Warach S. Multiple cerebral microbleeds: MRI marker of a diffuse hemorrhage-prone state. J Neuroimaging. Jan 2004;14(1):54-7. [Medline].

  8. Chen YW, Gurol ME, Rosand J, Viswanathan A, Rakich SM, Groover TR, et al. Progression of white matter lesions and hemorrhages in cerebral amyloid angiopathy. Neurology. Jul 11 2006;67(1):83-7. [Medline].

  9. Derex L, Nighoghossian N, Hermier M, Adeleine P, Philippeau F, Honnorat J, et al. Thrombolysis for ischemic stroke in patients with old microbleeds on pretreatment MRI. Cerebrovasc Dis. 2004;17(2-3):238-41. [Medline].

  10. Eng JA, Frosch MP, Choi K, et al. Clinical manifestations of cerebral amyloid angiopathy-related inflammation. Ann Neurol. Feb 2004;55(2):250-6. [Medline].

  11. Fan YH, Zhang L, Lam WW, Mok VC, Wong KS. Cerebral microbleeds as a risk factor for subsequent intracerebral hemorrhages among patients with acute ischemic stroke. Stroke. Oct 2003;34(10):2459-62. [Medline].

  12. Greenberg SM, Eng JA, Ning M, Smith EE, Rosand J. Hemorrhage burden predicts recurrent intracerebral hemorrhage after lobar hemorrhage. Stroke. Jun 2004;35(6):1415-20. [Medline].

  13. Greenberg SM, Finklestein SP, Schaefer PW. Petechial hemorrhages accompanying lobar hemorrhage: detection by gradient-echo MRI. Neurology. Jun 1996;46(6):1751-4. [Medline].

  14. Greenberg SM, Vonsattel JP, Stakes JW, et al. The clinical spectrum of cerebral amyloid angiopathy: presentations without lobar hemorrhage. Neurology. Oct 1993;43(10):2073-9. [Medline].

  15. Hart RG, Boop BS, Anderson DC. Oral anticoagulants and intracranial hemorrhage. Facts and hypotheses. Stroke. Aug 1995;26(8):1471-7. [Medline].

  16. Johnson KA, Gregas M, Becker JA, Kinnecom C, Salat DH, Moran EK, et al. Imaging of amyloid burden and distribution in cerebral amyloid angiopathy. Ann Neurol. Sep 2007;62(3):229-34. [Medline].

  17. Kidwell CS, Saver JL, Villablanca JP, Duckwiler G, Fredieu A, Gough K. Magnetic resonance imaging detection of microbleeds before thrombolysis: an emerging application. Stroke. Jan 2002;33(1):95-8. [Medline].

  18. Kim HS, Lee DH, Ryu CW, Lee JH, Choi CG, Kim SJ, et al. Multiple cerebral microbleeds in hyperacute ischemic stroke: impact on prevalence and severity of early hemorrhagic transformation after thrombolytic treatment. AJR Am J Roentgenol. May 2006;186(5):1443-9. [Medline].

  19. Massachusetts General Hospital. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 22-1996. Cerebral hemorrhage in a 69-year-old woman receiving warfarin. N Engl J Med. Jul 18 1996;335(3):189-96. [Medline].

  20. Nighoghossian N, Hermier M, Adeleine P, Blanc-Lasserre K, Derex L, Honnorat J, et al. Old microbleeds are a potential risk factor for cerebral bleeding after ischemic stroke: a gradient-echo T2*-weighted brain MRI study. Stroke. Mar 2002;33(3):735-42. [Medline].

  21. O'Donnell HC, Rosand J, Knudsen KA, et al. Apolipoprotein E genotype and the risk of recurrent lobar intracerebral hemorrhage. N Engl J Med. Jan 27 2000;342(4):240-5. [Medline].

  22. Ohtani R, Kazui S, Tomimoto H, et al. Clinical and radiographic features of lobar cerebral hemorrhage: hypertensive versus non-hypertensive cases. Intern Med. Jul 2003;42(7):576-80. [Medline].

  23. Roob G, Lechner A, Schmidt R, Flooh E, Hartung HP, Fazekas F. Frequency and location of microbleeds in patients with primary intracerebral hemorrhage. Stroke. Nov 2000;31(11):2665-9. [Medline].

  24. Rosand J, Hylek EM, O'Donnell HC, Greenberg SM. Warfarin-associated hemorrhage and cerebral amyloid angiopathy: a genetic and pathologic study. Neurology. Oct 10 2000;55(7):947-51. [Medline].

  25. Smith EE, Greenberg SM. Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria. Curr Atheroscler Rep. Jul 2003;5(4):260-6. [Medline].

  26. Thal DR, Ghebremedhin E, Orantes M, Wiestler OD. Vascular pathology in Alzheimer disease: correlation of cerebral amyloid angiopathy and arteriosclerosis/lipohyalinosis with cognitive decline. J Neuropathol Exp Neurol. Dec 2003;62(12):1287-301. [Medline].

  27. Vinters HV. Cerebral amyloid angiopathy. A critical review. Stroke. Mar-Apr 1987;DA - 19870518(2):311-24. [Medline].

  28. Viswanathan A, Chabriat H. Cerebral microhemorrhage. Stroke. Feb 2006;37(2):550-5. [Medline].

  29. Weller RO, Nicoll JA. Cerebral amyloid angiopathy: pathogenesis and effects on the ageing and Alzheimer brain. Neurol Res. Sep 2003;25(6):611-6. [Medline].

  30. Yamada M. Cerebral amyloid angiopathy: an overview. Neuropathology. Mar 2000;20(1):8-22. [Medline].

  31. Zweifler RM. Management of acute stroke. South Med J. Apr 2003;96:380-5. [Medline].

Further Reading

Keywords

cerebrovascular amyloidosis, cerebral amyloid angiopathy, congophilic angiopathy, dysphoric angiopathy, β-amyloid, beta-amyloid, Alzheimer's disease, intracranial hemorrhage, ICH, dementia, transient neurologic events, hereditary cerebral hemorrhage with amyloidosis, hereditary cerebral hemorrhage with amyloidosis-Dutch type, hereditary cerebral hemorrhage with amyloidosis-Icelandic type, HCHWA, cerebral microbleeds, stroke, ischemic strokes

Contributor Information and Disclosures

Author

Ravi S Menon, MD, Clinical Fellow in Stroke Diagnostic and Therapeutics, National Institute of Health, National Institute of Neurological Disorders and Stroke
Ravi S Menon, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, and American Stroke Association
Disclosure: Nothing to disclose.

Coauthor(s)

Jose G Merino, MD, Medical Director, Suburban Hospital Stroke Program
Jose G Merino, MD is a member of the following medical societies: American Heart Association and American Stroke Association
Disclosure: Nothing to disclose.

Vladimir C Hachinski, MD, MSc, DSc, FRCP(C), Professor, Departments of Medicine, Physiology, London Health Sciences Center, University of Western Ontario, Canada
Vladimir C Hachinski, MD, MSc, DSc, FRCP(C) is a member of the following medical societies: American Academy of Neurology, American Heart Association, American Neurological Association, and Ontario Medical Association
Disclosure: Mitsubi Tanaba Pharma Corporation Honoraria Speaking and teaching; Ferrer Group Honoraria Speaking and teaching

Medical Editor

Thomas A Kent, MD, Professor, Department of Neurology, Baylor College of Medicine; Neurology Care Line Executive, Michael E DeBakey Veterans Affairs Medical Center
Thomas A Kent, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, New York Academy of Sciences, Royal Society of Medicine, Sigma Xi, and Stroke Council of the American Heart Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Howard S Kirshner, MD, Professor of Neurology, Psychiatry and Hearing and Speech Sciences, Vice Chairman, Department of Neurology, Vanderbilt University School of Medicine; Director, Vanderbilt Stroke Center; Program Director, Stroke Service, Vanderbilt Stallworth Rehabilitation Hospital; Consulting Staff, Department of Neurology, Nashville Veterans Affairs Medical Center
Howard S Kirshner, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neurorehabilitation, National Stroke Association, Phi Beta Kappa, and Tennessee Medical Association
Disclosure: Boehringer Ingelheim Honoraria Speaking and teaching; BMS/Sanofi Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching

CME Editor

Matthew J Baker, MD, Consulting Staff, Collier Neurologic Specialists, Naples Community Hospital
Matthew J Baker, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Chief Editor

Helmi L Lutsep, MD, Professor, Department of Neurology, Oregon Health and Science University; Associate Director, Oregon Stroke Center
Helmi L Lutsep, MD is a member of the following medical societies: American Academy of Neurology and American Stroke Association
Disclosure: Co-Axia Consulting fee Review panel membership; Talecris Consulting fee Review panel membership; AGA Medical Consulting fee Review panel membership; Boehringer Ingelheim Honoraria Speaking and teaching; Concentric Medical Consulting fee Review panel membership; Abbott Consulting fee Consulting; Sanofi  Consulting

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