Cerebral amyloid angiopathy in an octogenarian

Abstract

Cerebral amyloid angiopathy presents with lobar intracerebral hemorrhage, dementia, or transient neurological events. It occurs due to beta-amyloid deposition in the media and adventitia of the small arteries, the capillaries of the leptomeninges, and the cerebral cortex. We present the case of an 80-year-old woman, previously independent, without disability or cognitive impairment, with a history of well-controlled systemic arterial hypertension, who consulted for a de novo seizure episode and neurological deficit. During the imaging follow-up, the presence of two bilateral parieto-occipital macrohemorrhages occurred at two different times during the evolution of the clinical picture. These findings were attributed to the presence of cerebral amyloid angiopathy. Finally, the patient died during hospitalization. In this case presentation, the diagnostic criteria to consider was that she had cerebral amyloid angiopathy. The prognosis and the reasons leading to death are discussed.