Iatrogenic cerebral amyloid angiopathy: a rare case beyond diagnostic criteria with 3 years follow-up

Excerpt

Cerebral amyloid angiopathy (CAA) is a small vessel disease characterized by amyloid depositions on the vessel wall. It is primarily seen in older adults and mostly sporadically. The familial and genetic forms of CAA were described but are not as common as sporadic CAA. Advanced imaging evidence of vessel wall amyloid deposits, genetic studies, and cerebrospinal fluid analysis allows evaluation for CAA before post-mortem examination [1]. Thus, a relatively new form called iatrogenic CAA has been recognized more easily lately. This entity is seen in younger patients with similar symptomatology with CAA. The underlying pathology is mainly considered “a prion-like transmission,” which leads to misfolded proteins aggregating and depositing in vessel walls in the brain. Although the time lag between contamination and symptomatic disease has been variable, the duration is over decades [2]. However, different aspects of iatrogenic CAA (iCAA) and follow-up information need to be better defined. In this case report, we present a young male patient with iCAA with a 3-year follow-up. In addition to the diagnostic work-up, we described clinical, imaging, and neuropsychological progression of the patient in detail. …