Cerebral Amyloid Angiopathy (CAA)/Amyloidoma
Last Updated: October 1, 2018
- 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 elderly
- Amyloidoma found in younger patients with mean age of 48
- Slightly more common in women (8:5)
- 40% of patients with CAA have Alzheimer’s disease
- Focal nonhemorrhagic masses
- Mass effect generally minimal/mild
- May show moderate/striking enhancement
- Often extends medially to lateral ventricular wall with fine radial enhancing margins
- Radiating pattern from the ventricular wall may help in the diagnosis
- Hyperdense, enhances
- Variable appearance
- Heterogeneous, though 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, though this is a fairly nonspecific finding.
For more information, please see the corresponding chapter in Radiopaedia.
Contributor: Sean Dodson, MD
Chao CP, et al. Cerebral Amyloid Angiopathy: CT and MR Imaging Findings. Radiographics. 2006; 26(5):1517-31.
Galluci M, et al. Neuroradiological findings in two cases of isolated amyloidoma of the central nervous system. Neuroradiology 2002; 44(4):333-337.
Gandhi D, et al. CT and MR Imaging of Intracerebral Amyloidoma: Case Report and Review of the Literature. Am J Neuroradiol. 2003; 24:519-522.
Haacke EM, et al. Imaging Cerebral Amyloid Angiopathy with Susceptibility-Weighted Imaging. AJNR. 2007; 28:316-17.
Landau D, et al. Cerebral amyloidoma mimicking intracranial tumor: a case report. Journal of Medical Case Reports. 2010; 20;4:308.
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