Department of Neurosurgery, Asanogawa General Hospital, Kanazawa, Japan.
Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Acta Neurochir (Wien). 2021 May;163(5):1451-1455. doi: 10.1007/s00701-021-04751-0. Epub 2021 Feb 13.
We retrospectively studied the T2 star (T2*)-weighted magnetic resonance imaging (MRI) of a 40-year-old patient diagnosed with symptomatic early-onset cerebral amyloid angiopathy (CAA), occurring 34 years following childhood neurosurgery using a cadaveric dural patch. Our findings revealed that CAA associated with cadaveric dural transplantation could progress rapidly, sometimes with bilateral bleeding. This microbleed evolution is suggestive of water-soluble amyloid-β transmission via cerebrospinal fluid alongside perivascular drainage pathways with deposition in the cerebral artery walls due to clearance disturbances. Multiple intracerebral hemorrhages associated with CAA with a childhood cadaveric dural graft should be considered a life-threatening medical complication.
我们回顾性研究了一位 40 岁患者的 T2 星（T2*-weighted）磁共振成像（MRI），该患者在儿童神经外科手术后 34 年出现症状性早发性脑淀粉样血管病（CAA），使用尸源硬脑膜补丁。我们的研究结果表明，与尸源硬脑膜移植相关的 CAA 可能会迅速进展，有时会出现双侧出血。这种微出血的演变提示通过脑脊液和血管周围引流途径传播的水溶性淀粉样β蛋白，由于清除障碍导致在脑动脉壁中沉积。与儿童尸源硬脑膜移植物相关的 CAA 引起的多发性脑内出血应被视为危及生命的医疗并发症。
