Article Text

Download PDFPDF
Cerebral amyloid angiopathy with related inflammation masquerading as crescendo transient ischaemic attacks
  1. Duncan Maddox1,
  2. Kayla Ward1,
  3. Thomas Robertson2,
  4. Mike Boggild1
  1. 1 Neurology, Townsville Hospital and Health Service, Townsville, Queensland, Australia
  2. 2 Neuropathology, Pathology Queensland, Herston, Queensland, Australia
  1. Correspondence to Dr Duncan Maddox, Neurology, Townsville Hospital and Health Service, Townsville, Queensland, Australia; duncan.maddox{at}health.qld.gov.au

Abstract

Cerebral amyloid angiopathy with related inflammation (CAA-RI) is an uncommon inflammatory subtype of CAA, with a variety of presentations that can mimic other focal and diffuse neurological disorders. We present a 63-year-old man with recurrent stereotyped focal neurological symptoms, who was initially diagnosed as capsular warning syndrome and treated with antithrombotic therapy. Atypical imaging led to further investigation including a cerebral biopsy, which confirmed CAA-RI; he improved clinically and radiologically with immunosuppression. This case highlights how CAA-RI is often under-recognised and that patients risk receiving inappropriate anticoagulation and delay in starting immunosuppression.

  • amyloid
  • neuroimmunology
  • neuropathology
  • neuroradiology
  • stroke

Statistics from Altmetric.com

Footnotes

  • Contributors DM compiled case report, collated radiology images, writing and editing. KW compiled literature review, introduction and discussion, writing and editing. TR provided histopathology images, provided expertise and insight into neuropathology. MB is in charge of patient’s care. Assisted with writing, editing and compilation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned: externally reviewed by Neil Scolding, Bristol, UK.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Editors’ commentary
    Phil E M Smith Geraint N Fuller
  • Editorial
    N J Scolding

Other content recommended for you