脳腫瘍や中枢神経感染症との鑑別を要したcerebral amyloid angiopathy related inflammation の1 例

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  • A case of cerebral amyloid angiopathy-related inflammation

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<p>We report a rare case of cerebral amyloid angiopathy-related inflammation. A 75-year-old man presented with sudden-onset of headache, left hemiplegia and sensory disturbance, followed by left hemispatial neglect, pseudopsia, behavior disorder, and seizure. Magnetic resonance imaging showed leptomeningeal enhancement along the parietal and occipital sulci without cortical-subcortical microhemorrhage. Examination of the cerebrospinal fluid revealed highly elevatedprotein with only a slightly increased cell count. Brain biopsy of the lesion showed vascular amyloid deposition in the leptomeningeal and parenchymal vessels with perivascular inflammation and abundant multi-nuclear giant cells, which suggested a diagnosis of cerebral amyloid angiopathy-related inflammation. The effect of pulse steroid therapy was equivocal and the clinical and radiological findings remainedunchanged, consistent with subacute leukoencephalopathy.</p>

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