Type:
Educational Exhibit
Keywords:
Performed at one institution, Not applicable, Pathology, Image verification, Haemorrhage, Surgery, Complications, Biopsy, MR, CT-Angiography, CT, Vascular, Neuroradiology brain, Haematologic, Neuro
Authors:
K. Sotomayor1, A. Bonilla2, M. NEGROTTO3, F. Bustamante1, C. Scelsi1, R. Figueroa1, S. Forseen1, B. Gilbert1, G. Palacios1; 1Augusta, GA/US, 2Lima/PE, 3Montevideo/UY
DOI:
10.26044/ecr2020/C-05803
Findings and procedure details
We describe five cases of CAA.
Table 1: Findings and procedure details.
References: Department of Radiology and Imaging, Medical College of Georgia, Augusta University/ Georgia- USA 2019.
Susceptibility-weighted images (SWI) were performed in all cases, which were all confirmed with histology.
Three patients were female.
All patients were over 65 years old.
Two patients presented with stroke-like symptoms, while the other three presented one each with seizure, altered mental status, and rapid cognitive impairment.
MR Imaging evaluation showed one patient with edema without hemorrhage [ Fig. 1, Fig. 10 ]; four patients with lobar hemorrhage [Fig. 5] (two of them had “code stroke” [Fig. 7]presentations, both requiring decompressive surgery).
Three patients received steroids with a good response and two, presented with mass-like variety[Fig. 3, Fig. 4] [Fig. 5 ].
The presence of diffuse cortical and subcortical microhemorrhages on SWI was the diagnostic key to suspect CAA, without being able to rule out tumor injury in the mass like variety, which could only be confirmed by pathology. [Fig. 6] [Fig. 8]