Analysis of Diagnosis and Treatment of 6 Cases of Cerebral Amyloid Angiopathy-related Inflammation

Abstract

Cerebral amyloid angiopathy associated with inflammation (CAA-ri) is characterized by an inflammatory response to the vascular deposits of β-amyloid within the brain that is a very rare subtype of cerebral amyloid angiopathy.The most common clinical manifestation of CAA-ri was headache, epilepsy, and cognitive dysfunction. Magnetic resonance imaging (MRI) showed focal or multiple white matter lesions, lobar intracerebral hemorrhage, extensive cortical or subcortical microbleeds. We reported 6 cases of probable CAA-ri diagnosed and treated in our hospital from January 2017 to September 2019 according to the revised diagnostic criteria in 2016.We found that 5 patients also had microbleeds and cortical superficial siderosison T2 and fluid-attenuated inversion recovery (FLAIR), suggesting that if the patients had a long course of disease, older age and heavy microbleeds load, the lesions could be found in the routine MRI, which is a clue for the diagnosis of CAA-ri. Clinicians should attach great importance to this phenomenon, and can further verify by susceptibility weighted imaging (SWI).