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Cerebral amyloid angiopathy

  • Alternative Names

    Amyloidosis - cerebral; CAA


    Symptoms

    Cerebral amyloid angiopathy can cause bleeding into the brain, usually in the outer parts of the brain, called the lobes, and not the deep areas. Symptoms occur because bleeding in the brain harms brain tissue. If there is a lot of bleeding, immediate symptoms occur and resemble a stroke. Such symptoms include:

    • Drowsiness
    • Headache (usually in a specific part of the head)
    • Neurologic changes that may start suddenly, including:
      • Confusion, delirium
      • Double vision, decreased vision
      • Sensation changes
      • Speech difficulties
      • Weakness or paralysis
    • Seizures
    • Stupor or coma (rarely)
    • Vomiting

    Other symptoms can include:

    • Episodes of confusion
    • Headaches that come and go
    • Loss of mental function (dementia)
    • Sensation changes (unusual sensations) that come and go
    • Seizures

    Signs and tests

    Cerebral amyloid angiopathy is difficult to diagnose with certainty without a sample of brain tissue. This is usually done after death or when a biopsy of the blood vessels of the brain is done.

    A physical exam can be relatively normal if you have a small bleed, but you may show some brain function changes. It is important for the doctor to ask detailed questions about your medical history. Your symptoms and the results of your physical exam and any imaging tests may cause your doctor to suspect this problem.

    A CT scan or MRI of the head may show:

    • Bleeding in the brain
    • Signs of prior bleeding in the brain

    Magnetic resonance angiography (MRA) of the brain can help with the diagnosis of large bleeds and may be used to rule out arteriovenous malformation or aneurysm as the cause of the bleed.

    Another type of MRI scan can help show tiny areas where blood has escaped from blood vessels into brain tissue.