Cerebral Amyloid Angiopathy/Amyloidoma
- Cerebrovascular disorder characterized by the deposition of amyloid protein in the media and adventitia of small- and medium-sized vessels of the cerebral cortex, subcortical white matter, and leptomeninges
- Thought to be related to a benign clonal proliferation of plasma cells
- Three varieties
- Cerebral amyloid angiopathy, amyloidoma, rare inflammatory subtype
- Seizures, headache, focal motor signs, and cognitive decline
- Angiopathy fairly common in the elderly population
- Amyloidoma found in younger patients; mean age, 48 years
- Slightly more common in women (8:5 female/male)
- 40% of patients with cerebral amyloid angiopathy have Alzheimer disease
- Focal nonhemorrhagic masses
- Mass effect is generally minimal/mild
- Might show moderate/striking enhancement
- Often extends medially to lateral ventricular wall with fine radial enhancing margins
- Radiating pattern from the ventricular wall can help with the diagnosis
- Modality specific
- Hyperdense, enhances
- Variable appearance
- Heterogeneous, although more commonly hyperintense
- Classic amyloid angiopathy can mimic treated or hemorrhagic metastases. The less common amyloidoma can mimic a neoplasm with or without hemorrhage. The radiating pattern from the ventricular wall, when present, can help in differentiating, although this is a fairly nonspecific finding
For more information, please see the corresponding chapter in Radiopaedia.
Contributor: Sean Dodson, MD
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Galluci M, Caulo M, Splendiani A, et al. Neuroradiological findings in two cases of isolated amyloidoma of the central nervous system. Neuroradiology 2002;44:333–337. doi.org/10.1007/s00234-001-0728-0
Gandhi D, Wee R, Goyal M. CT and MR imaging of intracerebral amyloidoma: case report and review of the literature. AJNR Am J Neuroradiol 2003;24:519–522.
Haacke EM, DelProposto ZS, Chaturvedi S, et al. Imaging cerebral amyloid angiopathy with susceptibility-weighted imaging. AJNR Am J Neuroradiol 2007;28:316–317.
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