Iatrogenic cerebral amyloid angiopathy: An illustrative case of a newly introduced disease

Abstract

Background and purposeIatrogenic cerebral amyloid angiopathy (iCAA) is a specific type of cerebral amyloid angiopathy which is becoming increasingly diagnosed. It has been hypothesized that iCAA might arise as a late consequence of past neurosurgical interventions involving dural patch grafts. Positron emission tomography (PET) scans with amyloid tracers and the assay of beta‐amyloid levels in cerebrospinal fluid (CSF) are auxiliary criteria, however, definite diagnosis remains histopathologically determined.MethodsCase report.ResultsWe present a 48‐year‐old patient who suffered multiple lobar cerebral haemorrhages from the age of 47. The patient had undergone surgery for remolval of hemangioblastoma with lyophilized dural graft at the age of 11, in 1987. Brain MRI, amiloid PET and CSF analysis led to a diagnosis of probable iCAA.ConclusionIt is necessary to increase the awareness of iCAA, in order to avoid overlooking the potential causal involvement of surgical procedures which took place far back in time. Moreover, the diagnostic relevance of amyloid PET and beta‐amyloid levels in CSF must be emphasised.

The novel imaging methods in diagnosis and assessment of cerebrovascular diseases: an overview

“…It can also be used to assess the viability of brain tissue in regions at risk of infarction before interventional procedures such as carotid endarterectomy. It can also be utilized for the detection and characterization of cerebral amyloid deposition in disorders like Alzheimer’s disease ( 89 , 90 ). The use of specific amyloid-targeting tracers allows for the quantification of amyloid plaques in the brain, aiding in diagnosis and monitoring disease progression ( 91 , 92 ).…”