Brunot S, Fromont A, Ricolfi F, Moreau T, Giroud M
Service de neurologie, hôpital Général, CHU de Dijon, 3, rue du Faubourg-Raines, 21033 Dijon cedex, France.
Rev Neurol (Paris). 2010 Jan;166(1):83-9. doi: 10.1016/j.neurol.2009.01.037. Epub 2009 Mar 17.
Cerebral amyloid angiopathy is a degenerative angiopathy due to amyloid deposits in the walls of the meningeal and cortical vessels. It is considered as a major cause of cerebral hemorrhage to the elderly. It was recently demonstrated that the association of focal meningeal bleedings and cerebral hemorrhage is very suggestive of cerebral amyloid angiopathy. In contrast, the links between subarachnoid hemorrhage and amyloid angiopathy are less well-known.
We report nine cases of cerebral amyloid angiopathy. The clinical presentation was variable, but all had at least one inaugural meningeal bleeding. As cortico-meningeal biopsies were not performed the Boston criteria were used to establish the diagnosis.
Cerebral amyloid angiopathy is an underestimated cause of subarachnoid hemorrhage. Our observations show that this diagnosis should be evoked when focal meningeal bleeding occurs without head trauma or when focal subarachnoid hemorrhage is followed by a subcortical hematoma in an elderly subject.
脑淀粉样血管病是一种由于淀粉样物质沉积于脑膜和皮质血管壁而导致的退行性血管病。它被认为是老年人脑出血的主要原因。最近有研究表明，局灶性脑膜出血与脑出血的关联强烈提示脑淀粉样血管病。相比之下，蛛网膜下腔出血与淀粉样血管病之间的联系则鲜为人知。
我们报告了9例脑淀粉样血管病病例。临床表现各异，但均至少有一次首发的脑膜出血。由于未进行皮质-脑膜活检，故采用波士顿标准来确立诊断。
脑淀粉样血管病是蛛网膜下腔出血一个被低估的病因。我们的观察结果表明，当老年患者在无头部外伤的情况下发生局灶性脑膜出血，或局灶性蛛网膜下腔出血后出现皮质下血肿时，应考虑这一诊断。
