Forme inflammatoire d'angiopathie cérébrale du sujet âgé

An 86-year-old woman presents with transient focal neurological signs followed by a rapidly progressive loss of autonomy with psychomotor slowing down, awareness disorders and seizures. Brain magnetic resonance imaging shows FLAIR white matter asymmetric hyperintensities, mass effect and multiple bilateral microbleeds. Clinical data and radiological findings lead to the diagnosis of probable cerebral amyloid angiopathy-related inflammation (CAAi). Corticosteroid therapy begins and provides rapid improvement of the clinical features. CAAi is a rare disease defined by the deposition of β amyloid proteins within the walls of brain vessels associated with perivascular inflammation. Diagnostic criteria were recently proposed in the literature. Identifying this rare type of cerebral amyloid angiopathy is crucial considering the efficiency of corticosteroids and/or immunosuppressive treatments.