Imaging Features in Cerebral Amyloid Angiopathy

Cerebral amyloid angiopathy is a disorder characterized by deposition of amyloid peptide in the media and adventitia of leptomeningeal and cortical vessels of the central nervous system. Amyloid deposition leads to vessel fragility and rupture, so, even if cerebral amyloid angiopathy can be asymptomatic, intracerebral hemorrhage is the most common clinical manifestation. A definitive diagnosis requires a brain biopsy; however, advances in diagnostic procedures, particularly neuroimaging, have enabled us to establish a diagnosis based on standardized clinical and radiologic criteria. In this article, we aimed to present a systematic review of cerebral amyloid angiopathy related disorders with regard to their epidemiology, pathophysiology, clinical features, neuroimaging biomarkers, diagnosis criteria, and treatment. We also focused attention on a rare, lesser-known form of inflammatory angiopathy attributed to amyloid: cerebral amyloid angiopathy associated with inflammatory process.

Learning Objective: To describe MR imaging findings of cerebral amyloid angiopathy related disorders and to define the diagnostic criteria that allows a presumptive diagnosis without the need for a brain biopsy.