Tumefactive cerebral amyloid angiopathy - related inflammation.

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY Neurological Sciences Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI:10.1007/s10072-024-07696-1

Thomai Stardeli, Sofia Kitmeridou, Panagiotis Ioannidis

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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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肿瘤活性脑淀粉样血管病--相关炎症。

导言：脑淀粉样变性血管病相关炎症（CAA-ri）源于脑血管壁内β淀粉样蛋白（Aβ）沉积的炎症反应。我们报告了一个病例，该病例的临床和影像学特征有助于引起对该病的怀疑，并导致尽早开始治疗：病例介绍：一名 72 岁的男子因认知能力下降并伴有行为改变一个月而被转诊。脑磁共振成像（MRI）显示，在T2*加权梯度回波（T2*-GRE）图像上，存在液体衰减反转恢复（FLAIR）非对称多灶性白质高密度（WMH）、多发性脑微出血（CMB）和皮质浅层鳞状上皮细胞增多（cSS）。排除了代谢性、感染性和肿瘤性病因后，患者服用了皮质类固醇，临床症状得以恢复。随访影像显示，WMHs 有所缓解，而 CMBs 负荷明显增加：讨论：临床神经科医生了解 CAA-ri 的临床和影像学特征有助于及时诊断和用药，这对于一种可以治疗的疾病至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurological Sciences 医学-临床神经学

CiteScore

6.10

自引率

3.00%

发文量

743

审稿时长

4 months

期刊介绍： Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.