Cerebral amyloid angiopathy manifesting as recurrent intracerebral hemorrhage
P. F. Finelli, N. Kessimian and P. W. Bernstein
Over a period of eight years, a normotensive woman experienced eight
strokelike episodes. Computed tomographic (CT) scans obtained during each
of the last seven episodes demonstrated intracerebral lobar hemorrhage.
Cerebral angiography and contrast-enhanced CT scans demonstrated no
underlying abnormality. Our patient had recurrent intracerebral hemorrhage
(ICH) with no predisposing factors or dementia. The clinical diagnosis was
primary cerebral amyloid angiopathy (CAA). Brain biopsy specimens
demonstrated light microscopic and ultrastructural evidence of amyloid in
cerebral arterioles. We believe that the combined clinical, CT, and
ultrastructural changes in this case are unique. Recurrent ICH visualized
by CT scanning has diagnostic value in CAA.
