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17-07-2024 | Cranial MRI | Neuro-Images

Tumefactive cerebral amyloid angiopathy – related inflammation

Authors: Thomai Stardeli, Sofia Kitmeridou, Panagiotis Ioannidis

Published in: Neurological Sciences | Issue 10/2024

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Abstract

Introduction

Cerebral amyloid angiopathy–related inflammation (CAA-ri) derives from inflammatory response to β-amyloid (Aβ) protein deposition within the cerebral blood vessel walls. We report a case that accentuates those clinical and imaging features that can contribute to raise suspicion for the condition and lead to early treatment initiation.

Case presentation

A 72-year-old man was referred with one-month history of cognitive decline along with behavioral alterations. Brain MRI showed fluid attenuated inversion recovery (FLAIR) asymmetrical multifocal white matter hyperintensities (WMHs) along with multiple cerebral microbleeds (CMBs) and cortical superficial siderosis (cSS) on T2*-weighted gradient-recalled echo (T2*-GRE) images. Metabolic, infectious, and neoplastic causes were excluded, and subsequently corticosteroids were administered to the patient resulting in clinical recovery. Imaging on follow-up disclosed remission of WMHs, while CMBs load increased significantly.

Discussion

Clinical neurologists’ acquaintance with the clinical and imaging features of CAA-ri allows prompt diagnosis and medication initiation, that is essential for a conceivably treatable condition.
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Metadata
Title
Tumefactive cerebral amyloid angiopathy – related inflammation
Authors
Thomai Stardeli
Sofia Kitmeridou
Panagiotis Ioannidis
Publication date
17-07-2024
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 10/2024
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-024-07696-1

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