Download PDF
CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(01): 56-57
DOI: 10.1590/0004-282X20190113
IMAGES IN NEUROLOGY

Transient focal neurological episodes - “amyloid spells”: a TIA mimic that should be recognized

Episódios neurológicos focais transitórios - “amyloid spells”: Um AIT mimic que deve ser reconhecido
Marx Lima de BARROS-ARAÚJO 
1   Universidade Federal do Piauí, Hospital Universitário, Teresina PI, Brasil;
,
Matheus Rocha de Seixas NOGUEIRA 
2   Universidade Federal do Piauí, Faculdade de Medicina, Teresina PI, Brasil.
,
Guilherme Marconi Guimarães Martins HOLANDA 
2   Universidade Federal do Piauí, Faculdade de Medicina, Teresina PI, Brasil.
,
Ícaro Araújo de SOUSA 
2   Universidade Federal do Piauí, Faculdade de Medicina, Teresina PI, Brasil.
,
Matheus Rodrigues CORRÊA 
2   Universidade Federal do Piauí, Faculdade de Medicina, Teresina PI, Brasil.
,
Pedro Jorge Luz Alves CRONEMBERGER 
2   Universidade Federal do Piauí, Faculdade de Medicina, Teresina PI, Brasil.
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

A 74-year-old woman was admitted to our hospital with a history of episodes of left-sided hemiparesis and numbness for few minutes. A brain MRI showed cortical subarachnoid blood and diffuse cortical microbleeds, compatible with a diagnosis of cerebral amyloid angiopathy, according to modified Boston criteria[1]. Other possible causes of the MRI findings, such as coagulopathy and traumatic brain injury, were excluded.

Cerebral amyloid angiopathy, a common cause of lobar hemorrhage in older patients, can also present with transient focal neurological episodes, which are sometimes known as ‘amyloid spells’. These are stereotyped, recurrent, transient episodes of numbness or weakness and may mimic a transient ischemic attack[1],[2],[3],[4],[5].

Zoom Image
Figure T2*-weighted gradient-recalled echo MRI of a 74-year-old woman who presented with transient neurological episodes. (A and B) Convexity subarachnoid hemorrhage and superficial cortical siderosis involving the right central sulcus (arrow). (C and D) Cortical microbleeds (arrowheads).'


Publication History

Received: 01 May 2019

Accepted: 02 May 2019

Article published online:
13 June 2023

© 2019. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Greenberg SM, Charidimou A. Diagnosis of cerebral amyloid angiopathy - Evolution of the Boston criteria. Stroke. 2018 Feb;49(2):491-7. https://doi.org/10.1161/STROKEAHA.117.016990
  • 2 Pontes-Neto OM, Auriel E, Greenberg SM. Advances in our Understanding of the Pathophysiology, Detection and Management of Cerebral Amyloid Angiopathy. Eur Neurol Rev. 2012;7(2):134-9. https://doi.org/10.17925/ENR.2012.07.02.134
  • 3 Charidimou A, Law R, Werring DJ. Amyloid “spells” trouble. Lancet. 2012 Nov;380(9853):1620. https://doi.org/10.1016/S0140-6736(12)61333-6
  • 4 Nadarajan V, Perry RJ, Johnson J, Werring DJ. Transient ischaemic attacks: mimics and chameleons. Pract Neurol. 2014 Feb;14(1):23-31. https://doi.org/10.1136/practneurol-2013-000782
  • 5 Charidimou A, Peeters A, Fox Z, Gregoire SM, Vandermeeren Y, Laloux P, et al. Spectrum of transient focal neurological episodes in cerebral amyloid angiopathy: multicentre magnetic resonance imaging cohort study and meta-analysis. Stroke. 2012 Sep;43(9):2324-30. https://doi.org/10.1161/STROKEAHA.112.657759