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Cerebral amyloid angiopathy with related inflammation masquerading as crescendo transient ischaemic attacks

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

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

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