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Atypical Clinical Manifestations of Cerebral Amyloid Angiopathy

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Abstract

Purpose

Cerebral amyloid angiopathy is a vasculopathy caused by β-amyloid deposition in cerebral arterioles and capillaries. It is closely linked to Alzheimer’s disease and predisposes elderly patients to intracerebral hemorrhage, transient focal neurological episodes, and cognitive impairment. Because of a predilection for symptomatic hemorrhage, particularly in the frontal lobes, cerebral amyloid angiopathy may also cause a dysexecutive syndrome.

Recent Findings

In this case series, we describe presentations of classic clinical dementia syndromes which are not are widely thought to be associated with cerebral amyloid angiopathy, namely logopenic variant primary progressive aphasia (n = 3), normal pressure hydrocephalus (n = 3), and Lewy body dementia (n = 2). In every case, after a clinical diagnosis was established, neuroimaging, brain biopsy, and/or autopsy confirmed the presence of cerebral amyloid angiopathy.

Summary

Cerebral amyloid angiopathy has significant clinical implications, and its ability to mimic and/or contribute to other clinical dementia syndromes can complicate its diagnosis. This series of cases broadens the range of clinical scenarios associated with cerebral amyloid angiopathy.

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Authors and Affiliations

  1. Department of Neurology, Vanderbilt University Medical Center, Medical Research Building III, 465 21st Avenue S, Suite 6160 (Office 6158C), Nashville, TN, 37240, USA

    Carolyn Akers, Lealani May Y. Acosta, Ciaran Considine, Daniel Claassen, Howard Kirshner & Matthew Schrag

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  1. Carolyn Akers
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  2. Lealani May Y. Acosta
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  3. Ciaran Considine
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  4. Daniel Claassen
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  5. Howard Kirshner
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  6. Matthew Schrag
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Correspondence to Matthew Schrag.

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Carolyn Akers, Lealani May Y. Acosta, Ciaran Considine, Daniel Claassen, Howard Kirshner, and Matthew Schrag each declare no potential conflicts of interest.

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Akers, C., Acosta, L.M.Y., Considine, C. et al. Atypical Clinical Manifestations of Cerebral Amyloid Angiopathy. Curr Neurol Neurosci Rep 19, 64 (2019). https://doi.org/10.1007/s11910-019-0981-4

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