Type:
Educational Exhibit
Keywords:
Hypertension, Haemorrhage, Dementia, Imaging sequences, MR, CT, Neuroradiology brain
Authors:
B. Futácsi, K. Karlinger; Budapest/HU
DOI:
10.1594/ecr2013/C-1839
Conclusion
CAA related bleedings represent only a small observable part of the disease.
Ageing populations and the high prevalence of CAA in the elderly seem to result in the rise in the total number of cases.
At the moment postmortem examination is still the gold standard for the diagnosis.
We have shown that CT scans are appropriate to assess the more characteristic forms of CAA macrohemorrhages: multilocular,
cortico-subcortically localized,
cascade like bleeding.
However,
when only atypical unilocular bleeding is present CT scans alone are not suitable for complete differential diagnosis.
In these situations – or in case of asymptomatic patients – MR provides additional information by microbleed detection with GRE (or T2*GRE) sequence.
Because CAA related bleedings are not image specific clinical information should always be considered in the assessment.
The Boston Criteria serve as a simple and effective categorization tool for this purpose.
At the moment early detection,
effective treatment and prevention of the disease are still limited.
The routine use of MRI is recommended,
while molecular imaging might provide future diagnostic opportunities.