CEREBRAL AMYLOID ANGIOPATHY

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Epidemiology

– MCC of recurrent ICH in elderly normotensive pts – Incidence rises after 70 yrs – Sporadic and familial forms (Iceland/Holland)

– Contractile elements of leptomeningeal and cortical arteries are replaced by non-contractile amyloid beta protein

– Amyloid deposits in media and adventitia of small and medium-sized arteries – Stain intensely with Congo red – Birefringence in polarized light

– Subcortical or lobar – Predominantly in the occipital and parietal lobes – Multiplicity over time and location

– TIA-like symptoms consisting of numbness, tingling or weakness involving the area where the hemorrhage will subsequently occur

– CT an MRI findings of multiple peripherally located hemorrhages of different ages