A 77 year-old men developed a subacute-onset, rapidly progressive cognitive
decline. After 6 months of evolution, he scored 6 on the Mini-Mental State
Examination and had left hemiparesis and hemineglect. The patient died 11 months
after the onset of cognitive symptoms. Brain MRI showed microhemorrhages on
gradient-echo sequence and confluent areas of white matter hyperintensities on
T2-weighted images. Brain biopsy revealed amyloid-β peptide deposition in
vessel walls, some of them surrounded by micro-bleeds. In this case report, we
discuss the role of cerebral amyloid angiopathy (CAA) in cognitive decline, due
to structural lesions associated with hemorrhages and infarcts, white matter
lesions and co-morbidity of Alzheimer’s disease, as well as the most recently
described amyloid angiopathy-related inflammation.
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