Cerebral Amyloid Angiopathy-Related Transient Focal Neurologic Episodes

Eric E Smith; Andreas Charidimou; Cenk Ayata; David J Werring; Steven M Greenberg

doi:10.1212/WNL.0000000000012234

Cerebral Amyloid Angiopathy-Related Transient Focal Neurologic Episodes

Neurology. 2021 Aug 3;97(5):231-238. doi: 10.1212/WNL.0000000000012234. Epub 2021 May 20.

Authors

Eric E Smith¹, Andreas Charidimou², Cenk Ayata², David J Werring², Steven M Greenberg²

Affiliations

¹ From the Department of Clinical Neurosciences (E.E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Hemorrhagic Stroke Research Program (A.C., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School; Stroke Service and Neurovascular Research Lab (C.A.), Department of Neurology, Massachusetts General Hospital, Boston; and Stroke Research Centre (D.J.W.), University College London Queen Square Institute of Neurology, UK. [email protected].
² From the Department of Clinical Neurosciences (E.E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Hemorrhagic Stroke Research Program (A.C., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School; Stroke Service and Neurovascular Research Lab (C.A.), Department of Neurology, Massachusetts General Hospital, Boston; and Stroke Research Centre (D.J.W.), University College London Queen Square Institute of Neurology, UK.

Abstract

Transient focal neurologic episodes (TFNEs) are brief disturbances in motor, somatosensory, visual, or language functions that can occur in patients with cerebral amyloid angiopathy (CAA) and may be difficult to distinguish from TIAs or other transient neurologic syndromes. They herald a high rate of future lobar intracerebral hemorrhage, making it imperative to differentiate them from TIAs to avoid potentially dangerous use of antithrombotic drugs. Cortical spreading depression or depolarization triggered by acute or chronic superficial brain bleeding, a contributor to brain injury in other neurologic diseases, may be the underlying mechanism. This review discusses diagnosis, pathophysiology, and management of CAA-related TFNEs.

Publication types

Review

MeSH terms

Cerebral Amyloid Angiopathy / complications*
Cerebral Amyloid Angiopathy / diagnostic imaging
Humans
Nervous System Diseases / diagnostic imaging
Nervous System Diseases / etiology*