Interactive Transcript
0:00
This next patient had some memory loss, and what we see here is
0:05
multiple foci of old hemosiderin staining on the GRE sequence. So This looks
0:11
like a cerebral amyloid angiopathy case. But on the T2 weighted image here,
0:15
we see extensive T2 hyperintensity surrounding these zones of GRE susceptibility
0:20
artifact. So this is actually cerebral amyloid angiopathy with inflammation.
0:26
On the FDG PET here, we had some cortical hypometabolism in the bilateral
0:32
parietal lobes, which you see more profoundly here on the right hand side.
0:36
And as we mentioned before, APOE4 is a significant risk factor for cerebral
0:41
amyloid angiopathy. One interesting fact is cerebral amyloid angiopathy
0:46
is found in 5% of the general population, but in 80%
0:51
of patients with Alzheimer's disease. So that's a really big number.
0:54
Again, I believe it comes down to the pathway of a beta amyloid
0:59
deposition from the APOE40 and the APOE42 with disruption of that pathway
1:06
in terms of either production or degradation of those products and then
1:11
accumulation along the vessel walls in the cortex.
1:16
This is another case here of cerebral amyloid angiopathy with inflammation.
1:21
Here's the initial presentation where we have this big bleed in the right
1:24
temporal lobe. We also have multiple other little foci of old hemosiderin
1:28
staining. And then on the FLAIR sequence, we see surrounding FLAIR hyperintensity.
1:33
So this was a CAA with inflammation. One week following steroid therapy,
1:39
the blood products are still there, but that surrounding inflammation has
1:42
gone down. So steroids are very helpful when you have inflammation with
1:47
CAA. This patient happened to be a 71 year old woman with headache
1:51
and cognitive change. Now, this type of appearance is very similar to an
1:55
ARIA appearance. ARIA stands for amyloid related imaging abnormalities,
1:59
which we're going to talk about very shortly.
© 2024 MRI Online. All Rights Reserved.