Cerebral amyloid angiopathy is a neurological condition in which proteins called amyloid build up on the walls of the arteries in the brain. The condition increases the risk of hemorrhagic stroke and dementia.
Amyloidosis - cerebral; CAA
Causes, incidence, and risk factors
The cause of cerebral amyloid angiopathy is unknown. Sometimes, it may be passed down through families.
Persons with this condition have deposits of amyloid protein in the walls of the brain arteries. The protein is usually not deposited anywhere else in the body.
The major risk factor is increasing age. It is more often seen in those older than 60.
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:
Sensation changes (unusual sensations) that come and go
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.
Another type of MRI scan can help show tiny areas where blood has escaped from blood vessels into brain tissue.
There is no known effective treatment. The goal of treatment is to relieve symptoms. In some cases, rehabilitation is needed for weakness or clumsiness. This can include physical, occupational, or speech therapy.
Occasionally, some patients may benefit from medications that help improve memory, such as those used to treat Alzheimer's disease.
Seizures, sometimes called “amyloid spells,” may be treated with anticonvulsants such as phenytoin (Dilantin) and carbamazepine (Tegretol).
The disorder slowly gets worse but varies from person to person.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.