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http://crossmark.crossref.org/dialog/?doi=10.1007/s00701-016-3004-0&domain=pdf
Web End = Acta Neurochir (2017) 159:1518 DOI 10.1007/s00701-016-3004-0
http://crossmark.crossref.org/dialog/?doi=10.1007/s00701-016-3004-0&domain=pdf
Web End = CASE REPORT - VASCULAR
Cerebral amyloid angiopathy in a young man with a history of traumatic brain injury: a case report and reviewof the literature
Yoichi Nakayama1 & Yohei Mineharu1 & Yoshiki Arawaka1 & Sei Nishida1 &
Hirofumi Tsuji1 & Hidehiko Miyake2 & Maki Yamaguchi3 & Sachiko Minamiguchi3 &
Yasushi Takagi1 & Susumu Miyamoto1
http://orcid.org/0000-0002-6346-3999
Web End = Received: 12 August 2016 /Accepted: 19 October 2016 /Published online: 4 November 2016 # Springer-Verlag Wien 2016
Abstract Cerebral amyloid angiopathy (CAA), a cause of recurrent and multiple lobar hemorrhages, characteristically occurs in persons aged 55 years. We report a case of a 32-year-old male who had recurrent hemorrhage in the left multiple lobes, with a history of traumatic brain injury and hematoma evacuation at the age of 1 year. He underwent surgical treatment and was histopathologically diagnosed as having CAA. The literature review yielded six CAA cases, including ours, aged less than 55 years. All were male and four had histories of severe TBI, suggesting that male sex and TBI may be associated with CAA in young persons.
Keywords Amyloid angiopathy . Cerebral . Lobar hemorrhage . Traumatic brain injury . Young
Introduction
Cerebral amyloid angiopathy (CAA) is a progressive form of microvascular amyloidosis that characteristically oc-curs in the elderly [4]. According to the Boston criteria,
an age of 55 years is required to diagnose Bprobable^ or Bpossible^ CAA without histopathological examinations [9]; however, some younger patients have been reported as having this condition [1, 2, 7, 10].
Case Report
A 32-year-old male complained of severe headaches, and CT showed a left occipital lobe hemorrhage (Fig. 1a). He had a history of TBI. He had fallen from a chair at age 1 year and suffered from a subdural hematoma in the left frontal lobe, for which he had undergone craniotomy and evacuation of a hematoma. Radiological follow-up for the TBI has not been made. Results of laboratory tests were unremarkable. Fluid attenuation inversion recovery (FLAIR) images of magnetic resonance imaging (MRI) showed diffuse white matter lesions (Fig. 2a-b), and susceptibility-weighted images (SWIs) showed multifocal old hemorrhagic lesions in both the supratentorial and infratentorial parenchyma (Fig. 2cd). Despite his young age, we suspected...