Abstract
Cerebral amyloid angiopathy (CAA) is cerebrovascular amyloid deposition. It is classified
into several types according to the cerebrovascular amyloid proteins involved. Sporadic
amyloid β-protein (Aβ)-type CAA is commonly found in elderly individuals and patients
with Alzheimer disease. CAA-related disorders include hemorrhagic and ischemic stroke
and dementia. CAA-related hemorrhages include intracerebral lobar macrohemorrhages,
cortical microhemorrhages, and focal subarachnoidal hemorrhages/superficial siderosis.
CAA-associated vasculopathies, such as microaneurysmal formation with fibrinoid necrosis,
underlie such cerebrovascular events. Sensitive magnetic resonance imaging procedures,
such as gradient-echo T2* imaging and susceptibility-weighted images, are useful to
detect microhemorrhagic lesions. Amyloid images with amyloid-binding positron emission
tomography ligands can detect CAA, although they cannot discriminate vascular from
parenchymal amyloid deposits. Hemorrhage-inducing factors for sporadic Aβ-type CAA
include apolipoprotein E genotype, thrombolytic, anticoagulation, and antiplatelet
therapies, hypertension, minor head trauma, and antiamyloid therapies. We need future
strategies for protection of vessel walls against amyloid-related vascular damage,
such as toxicity of Aβ oligomers, Aβ-induced oxidative stress, and inflammation, as
well as development of antiamyloid therapies for CAA.
Keywords
cerebral amyloid angiopathy - intracerebral hemorrhage - cerebrovascular disorders
- amyloid β-protein - risk factors
