Fossas P, Barrufet P, Andreu J, Navarro C
Unidad de Neurología, Hospital L'Aliança Mataronina, Mataró.
Neurologia. 1992 Mar;7(3):109-12.
Cerebral amyloid angiopathy (CAA) is an almost constant finding in Alzheimer's disease and in Alzheimer type senile dementia (EA/DSTA) but it has also been described in association with other processes such as in age-related hereditary or non hereditary cerebral hemorrhage (CH) relapse. The case of a non hypertensive 78 year old women is presented. Over a period of 27 months the patient had 3 cerebral hemorrhages located in the left parietotemporal, caudate nucleus and right frontobasal and right parietotemporal lobes, all of which had cortico-subcortical topography and eruption of blood to the subarachnoid space. The fundamental finding in the neuropathological study was the CAA with massive involvement in the leptomeninges and cortex, less in cerebellum and nucleus of the base, occasional in white matter and absent in the brain stem trunk. Abundant senile plaques and figures of neurofibrillar degeneration were found. Granulovacuolar degeneration or Hyrano bodies were not observed. At the level of the main intracraneal arterial trunks only a small plaque of atheroma was observed in the left vertebral artery. The association of CAA and CH in the literature and their relation with EA/DSTA are revised.
脑淀粉样血管病（CAA）在阿尔茨海默病和阿尔茨海默型老年痴呆症（EA/DSTA）中几乎是一个常见的发现，但也有文献报道其与其他疾病相关，如与年龄相关的遗传性或非遗传性脑出血（CH）复发。本文报告了一例78岁非高血压女性患者的病例。在27个月的时间里，该患者发生了3次脑出血，分别位于左侧顶颞叶、尾状核、右侧额基底和右侧顶颞叶，所有出血均具有皮质-皮质下特征且血液破入蛛网膜下腔。神经病理学研究的主要发现是CAA，软脑膜和皮质广泛受累，小脑和基底核受累较少，白质偶有受累，脑干未受累。同时发现大量老年斑和神经原纤维变性。未观察到颗粒空泡变性或 Hirano 小体。在主要的颅内动脉干水平，仅在左侧椎动脉发现一小片动脉粥样硬化斑块。本文还综述了文献中CAA与CH的关联及其与EA/DSTA的关系。
