Scientific correspondence

Jd, Marotti; Si, Savitz; Wk, Kim; Williams, Korwyn; Lr, Caplan; Jt, Joseph

doi:10.1111/j.1365-2990.2007.00843.x

Cited by 14 publications

(7 citation statements)

References 24 publications

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“…In patient 2, although inflammation could not be demonstrated, the exclusion of other etiologies, the detection of CAA on brain biopsy, the favorable outcome under immunosuppressive therapy and mostly, the evolution toward typical imaging features of CAA strongly support the diagnosis of CAA-RI. The patchy and segmental distribution of inflammation may also actually cause false negative results on brain biopsy, as previously reported (3, 4).…”

Section: Discussionsupporting

confidence: 54%

Cerebral Amyloid Angiopathy Related Inflammation With Prominent Meningeal Involvement. A Report of 2 Cases

et al. 2019

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Cerebral amyloid angiopathy related inflammation (CAA-RI) is a rare form of CAA characterized by subacute encephalitic symptoms (cognitive decline, seizures, focal deficits) associated with extensive and confluent white matter lesions co-localizing with lobar microbleeds on brain MRI. We report two cases of unusual CAA-RI mimicking meningoencephalitis but without typical brain lesions on FLAIR and T2* sequences. These 2 cases may extend the clinical spectrum of CAA-RI by suggesting the possible occurrence of quite purely meningeal forms of CAA-RI.

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Section: Discussionsupporting

confidence: 54%

Cerebral Amyloid Angiopathy Related Inflammation With Prominent Meningeal Involvement. A Report of 2 Cases

et al. 2019

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“…Aβ phagocytosis was described in 36.2%, including our two cases, involving MNGCs in 74.0%, macrophages/histiocytes in 48.0% and microglia in 20.0% of them. The reports are somewhat discordant regarding the association of infiltrates with CAA, with most authors reporting only CAA‐affected vessels to be associated with inflammation [7, 10, 43, 44], whereas others describe (seemingly) non‐CAA vessels to be involved as well [32, 34, 41], in a case with exclusive association in biopsy and near‐absolute dissociation at autopsy [45]. Some authors propose efficient immunological clearance of Aβ to underlie these observations [45].…”

Section: Resultsmentioning

confidence: 99%

“…Transmural involvement and perivascular-only involvement were frequently reported to co-occur in patients [8,[32][33][34][35][36][37], suggesting that these might represent a spectrum. In addition, CAA-RI in one report was found to be perivascular by biopsy and transmural at autopsy [38],…”

Section: Nomenclaturementioning

confidence: 99%

Identifying diagnostic and prognostic factors in cerebral amyloid angiopathy‐related inflammation: A systematic analysis of published and seven new cases

Szalardy,

Fakan,

Maszlag‐Torok

et al. 2024

Neuropathology Appl Neurobio

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AimsCerebral amyloid angiopathy‐related inflammation (CAA‐RI) is a potentially reversible manifestation of CAA, histopathologically characterised by transmural and/or perivascular inflammatory infiltrates. We aimed to identify clinical, radiological, and laboratory variables capable of improving or supporting the diagnosis of or predicting/influencing the prognosis of CAA‐RI and to retrospectively evaluate different therapeutic approaches.MethodsWe present clinical and neuroradiological observations in seven unpublished CAA‐RI cases, including neuropathological findings in two definite cases. These cases were included in a systematic analysis of probable/definite CAA‐RI cases published in the literature up to December 31, 2021. Descriptive and associative analyses were performed, including a set of clinical, radiological, and laboratory variables to predict short‐term, 6‐month, and 1‐year outcomes and mortality, first on definite, secondly on an expanded probable/definite CAA‐RI cohort.ResultsData on 205 definite and 100 probable cases were analysed. CAA‐RI had a younger symptomatic onset than non‐inflammatory CAA, without sex preference. Transmural histology was more likely to be associated with the co‐localisation of microbleeds with confluent white matter hyperintensities on MRI. Incorporating leptomeningeal enhancement and/or sulcal non‐nulling on fluid‐attenuated inversion recovery (FLAIR) enhanced the sensitivity of the criteria. Cerebrospinal fluid pleocytosis was associated with a decreased probability of clinical improvement and longer‐term positive outcomes. Future lobar haemorrhage was associated with adverse outcomes, including mortality. Immunosuppression was associated with short‐term improvement, with less clear effects on long‐term outcomes. The superiority of high‐dose over low‐dose corticosteroids was not established.ConclusionsThis is the largest retrospective associative analysis of published CAA‐RI cases, and the first to include an expanded probable/definite cohort to identify diagnostic/prognostic markers. We propose points for further crystallisation of the criteria and directions for future prospective studies.

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“…Fusion of the hemispheric cortical pyramidal cell dendrites with the microglia cells in viral infection was revealed [8]. Studies of AIDS infection revealed heretofore unknown fusion of many "brain cells" with the formation of multinuclear giant cells in encephalitis and dementia, in tuberous sclerosis, leukoencephalitis [13], and other diseases. Hence, it was persuasively shown that the neurons were in principle capable of forming the syncytium and fusing with cells of other types.…”

mentioning

confidence: 98%

“…Methods for artificial cell fusion induction by excessive exposure to electric current [15] or pathological exposure to laser have been developed. Fusion of "brain cells" in viral diseases have been described previously [10,13]. It seems that the membranes acquire capacity to fusion and molecular instability, paralleled by perforations of fused membranes (metastable membranes) in many local and common pathological processes [7].…”

mentioning

confidence: 98%

The Problem of Neuronal Syncytical Connection in Disease

Арчакова

Novakovskaya

et al. 2009

Bull Exp Biol Med

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The membranes of neuron profiles adjacent to each other in the caudal mesenteric ganglion were examined electron microscopically during the first 3 days after crossing of the preganglionar or postganglionar branches. The contacting membranes were thinned and perforated, and neuron-to-neuron syncytial connections were forming. Multiple connections were formed between the nerve processes and terminals in the synapse. The pre- and even postsynapses were clear in pronounced perforations.

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Scientific correspondence

Cited by 14 publications

References 24 publications

Cerebral Amyloid Angiopathy Related Inflammation With Prominent Meningeal Involvement. A Report of 2 Cases

Cerebral Amyloid Angiopathy Related Inflammation With Prominent Meningeal Involvement. A Report of 2 Cases

Identifying diagnostic and prognostic factors in cerebral amyloid angiopathy‐related inflammation: A systematic analysis of published and seven new cases

The Problem of Neuronal Syncytical Connection in Disease

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