PMID- 29883923
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240328
IS  - 2210-2612 (Print)
IS  - 2210-2612 (Electronic)
IS  - 2210-2612 (Linking)
VI  - 48
DP  - 2018
TI  - Cerebral amyloid angiopathy-related inflammation with epilepsy mimicking a 
      presentation of brain tumor: A case report and review of the literature.
PG  - 95-100
LID - S2210-2612(18)30186-X [pii]
LID - 10.1016/j.ijscr.2018.05.016 [doi]
AB  - INTRODUCTION: Cerebral amyloid angiopathy-related inflammation (CAA-ri), a rare 
      and treatable variant of cerebral amyloid angiopathy, lacks specific imaging and 
      clinical features, and requires invasive brain biopsy to confirm the diagnosis. 
      We report the case of a patient with nonconvulsive status epilepticus (NCSE) 
      caused by CAA-ri in the right occipital lobe. PRESENTATION OF CASE: A 78-year-old 
      man with a history of hypertension and rheumatoid arthritis was admitted to our 
      hospital following an episode of seizures. CT scan showed a low-attenuating 
      subcortical lesion in the right occipital lobe. MRI revealed the lesion as 
      hypointense on T1-weighted imaging (WI) and hyperintense on T2-WI, showing no 
      enhancement on T1-WI contrast-enhanced with gadolinium. In addition, T2*-weighted 
      gradient-recalled echo (T2*-GRE) and susceptibility-weighted imaging (SWI) 
      revealed extensive cortical microbleeds. Biopsy to determine the exact diagnosis 
      revealed histological findings of reactive changes and perivascular inflammatory 
      infiltration associated with amyloid deposition in vessel walls. These findings 
      were consistent with CAA-ri. Corticosteroid therapy with dexamethasone was 
      initiated for a short period as a diagnostic and therapeutic maneuver, resulting 
      in marked reductions in the lesion. DISCUSSION: CAA is generally associated with 
      intracerebral hemorrhage, dementia, and small cerebral infarctions in the elderly 
      population, but in a small proportion of cases is related to inflammatory 
      responses to vascular deposits of Abeta, as so-called CAA-ri. CONCLUSION: CAA-ri 
      should be considered among the differential diagnoses for causes of unprovoked 
      seizure onset in elderly individuals, when associated with petechial hemorrhages 
      on T2*-GRE and SWI sequences on MRI.
CI  - Copyright (c) 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
FAU - Kusakabe, Kosuke
AU  - Kusakabe K
AD  - Department of Neurosurgery, Ehime University School of Medicine, 454 Shitsukawa, 
      Toon, Ehime 791-0295, Japan.
FAU - Inoue, Akihiro
AU  - Inoue A
AD  - Department of Neurosurgery, Ehime University School of Medicine, 454 Shitsukawa, 
      Toon, Ehime 791-0295, Japan. Electronic address: iakihiro@m.ehime-u.ac.jp.
FAU - Matsumoto, Shirabe
AU  - Matsumoto S
AD  - Department of Neurosurgery, Ehime University School of Medicine, 454 Shitsukawa, 
      Toon, Ehime 791-0295, Japan.
FAU - Kurata, Mie
AU  - Kurata M
AD  - Division of Diagnostic Pathology, Ehime University Hospital, 454 Shitsukawa, 
      Toon, Ehime 791-0295, Japan.
FAU - Kitazawa, Riko
AU  - Kitazawa R
AD  - Division of Diagnostic Pathology, Ehime University Hospital, 454 Shitsukawa, 
      Toon, Ehime 791-0295, Japan.
FAU - Watanabe, Hideaki
AU  - Watanabe H
AD  - Department of Neurosurgery, Ehime University School of Medicine, 454 Shitsukawa, 
      Toon, Ehime 791-0295, Japan.
FAU - Kunieda, Takeharu
AU  - Kunieda T
AD  - Department of Neurosurgery, Ehime University School of Medicine, 454 Shitsukawa, 
      Toon, Ehime 791-0295, Japan.
LA  - eng
PT  - Journal Article
DEP - 20180529
PL  - Netherlands
TA  - Int J Surg Case Rep
JT  - International journal of surgery case reports
JID - 101529872
PMC - PMC6041117
OTO - NOTNLM
OT  - Cerebral amyloid angiopathy-related inflammation
OT  - Epilepsy
OT  - Mimicking brain tumor
OT  - Susceptibility-weighted imaging
OT  - beta-Amyloid protein
EDAT- 2018/06/09 06:00
MHDA- 2018/06/09 06:01
PMCR- 2018/05/29
CRDT- 2018/06/09 06:00
PHST- 2018/02/13 00:00 [received]
PHST- 2018/04/24 00:00 [revised]
PHST- 2018/05/14 00:00 [accepted]
PHST- 2018/06/09 06:00 [pubmed]
PHST- 2018/06/09 06:01 [medline]
PHST- 2018/06/09 06:00 [entrez]
PHST- 2018/05/29 00:00 [pmc-release]
AID - S2210-2612(18)30186-X [pii]
AID - 10.1016/j.ijscr.2018.05.016 [doi]
PST - ppublish
SO  - Int J Surg Case Rep. 2018;48:95-100. doi: 10.1016/j.ijscr.2018.05.016. Epub 2018 
      May 29.