Raposo, N., Sonnen, J. A. September 3, 2017

Sporadic cerebral amyloid angiopathy (CAA) is a common age-related cerebral small vessel disease characterized by progressive deposition of amyloidal protein made up of (with rare exception) amyloid-β (Aβ) in the media and adventitia of cortical and leptomeningeal vessels.1 Lobar intracerebral hemorrhage (ICH) represents a late, often devastating manifestation of the disease, leading to high mortality, poor functional outcome, and dementia. Definite CAA diagnosis requires a full postmortem neuropathologic examination. However, brain MRI can help to diagnose CAA during life by detecting hemorrhagic lesions such as lobar cerebral microbleeds and cortical superficial siderosis. The modified Boston criteria include these MRI hemorrhagic markers and show a sensitivity of 95% and a specificity of 82% for probable CAA diagnosis.2 These hemorrhagic lesions may represent late and irreversible steps in the pathways leading from vascular dysfunction to brain injury. In vivo detection of vascular amyloidal protein might help early diagnosis of CAA.


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