J Korean Neurol Assoc.  1998 Oct;16(5):718-723.

Cerebral Amyloid Angiopathy Presenting with Progressive Dementia

• Kim YB
• Na DL
• Seo YL
• Lee SJ
• Lee KH
• Kim JS

Abstract

Cerebral amyloid angiopathy (CAA) can present with lobar hemorrhage, progressive dementia, or transient neurologic symptoms. To date, Pathology-confirmed CAA which presented with progressive dementia has rarely been repored in Korea. A 79-year-old normotensive man presented with progressive dementia for one year. Neurologic examination was remarkable for hyperreflexia and bilateral grasp response. Mild parkinsonian feature was also present. Cognitive domains impaired on neuropsychological test included verbal and nonverbal memory, language, visuospatial function and frontal/executive function. Brain MRI, especially gradiant-echo imaging, showed multiple microhemorrhages in the cortical areas along with leukoaraosis. Six months after initial evaluation, he developed massive ICH involving right frontal lobe with midline shift. Hematoma removal as well as cortical biopsy was performed. Cortical and meningeal vessels were thickened with amorphous materials showing apple-green birefringence, a feature consistent with CAA. CAA should be suspected in patient with subacute dementia when their MRI shows cortical microhemorrhage and leukoaraiosis.

Keyword

dementia; amyloid angiopathy; hemorrhage

MeSH Terms

Aged
Biopsy
Birefringence
Brain
Cerebral Amyloid Angiopathy*
Dementia*
Frontal Lobe
Hand Strength
Hematoma
Hemorrhage
Humans
Korea
Leukoaraiosis
Magnetic Resonance Imaging
Memory
Neurologic Examination
Neurologic Manifestations
Neuropsychological Tests
Reflex, Abnormal