| Cortical petechial hemorrhage, subarachnoid hemorrhage and corticosteroid-responsive leukoencephalopathy in a patient with cerebral amyloid angiopathy. | |
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MedLine Citation:
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PMID: 18266123 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We describe a 69-year-old woman who developed subacute onset cognitive decline after hitting the left side of her head. Cerebral spinal fluid showed yellowish discoloration with highly elevated protein content. FLAIR MRI revealed diffuse high signal intensity in all cortical sulci, and leptomeningeal enhancement in the left cerebral hemisphere was seen in the T1 image after contrast administration. She was treated with a corticosteroid. Consciousness disturbance was temporarily relieved but again worsened, resulting in an apathetic state due to communicating hydrocephalus. A shunt tube was placed in her right lateral ventricle. A brain biopsy disclosed multiple cortical microbleeds and heavy deposition of Abeta-immuoreactive amyloid on vascular walls. Inflammatory mononuclear cells surrounded a few leptomeningeal vessels. After the operation her condition further deteriorated and she fell into a coma. MRI showed diffuse swelling of the right cerebral white matter. She again received high-dose corticosteroid and gradually recovered during the following 2 months. On MRI the vast majority of abnormal signals in the right cerebral white matter disappeared. An initial manifestation of this patient was possibly caused by multiple microhemorrhages from fragile cortical and subarachnoid vessels with Abeta-amyloid deposition, which was triggered by head trauma. CAA-related inflammation possibly worsened this condition. Additionally, surgical intervention for communicating hydrocephalus might have induced cerebral amyloid angiopathy (CAA)-related leukoencephalopathy in her right cerebral hemisphere. These CAA-derived manifestations are unusual and high-dose corticosteroids seems to be useful for vascular events in CAA patients. |
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Authors:
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Kazuko Machida; Kana Tojo; Ko-Suke Naito; Takahisa Gono; Yoshikazu Nakata; Shu-Ichi Ikeda |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis Volume: 15 ISSN: 1350-6129 ISO Abbreviation: Amyloid Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-02-12 Completed Date: 2008-06-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9433802 Medline TA: Amyloid Country: United States |
Other Details:
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Languages: eng Pagination: 60-4 Citation Subset: IM |
Affiliation:
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Department of Medicine (Neurology and Rheumatology), School of Medicine, Shinshu University, Matsumoto, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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administration & dosage* Aged Cerebral Amyloid Angiopathy / etiology*, pathology, therapy* Dementia, Vascular / complications*, pathology, therapy* Female Humans Hydrocephalus / complications, pathology, therapy Subarachnoid Hemorrhage / complications*, pathology, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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