Cerebral amyloid angiopathy: clinical presentations and management challenges in the Australian context

Intern Med J. 2023 Jun;53(6):907-916. doi: 10.1111/imj.15999. Epub 2023 Jan 13.

Abstract

Cerebral amyloid angiopathy (CAA) is a disease with several clinical manifestations. It is characterised by amyloid-beta deposition in cerebral blood vessels, making them prone to bleeding. The incidence of CAA increases with age and may be associated or co-exist with intraparenchymal neurodegenerative proteinopathies, which makes it an increasingly relevant condition for adult physicians in all areas of medical practice. The vast majority of cases of CAA are sporadic with a small minority of familial cases. CAA is asymptomatic in many older adults but increases the risk of fatal intracerebral or subarachnoid haemorrhage. We review the existing literature on CAA and summarise the key findings. We specifically explore clinical challenges relevant to CAA, particularly in diagnosis, management of intracranial haemorrhage and management of concurrent medical conditions.

Keywords: anticoagulation; beta-amyloid; cerebral amyloid angiopathy; microhaemorrhages; superficial cortical siderosis.

Publication types

  • Review

MeSH terms

  • Aged
  • Australia / epidemiology
  • Cerebral Amyloid Angiopathy* / diagnosis
  • Cerebral Amyloid Angiopathy* / epidemiology
  • Cerebral Amyloid Angiopathy* / therapy
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / epidemiology
  • Humans
  • Incidence
  • Intracranial Hemorrhages / complications
  • Magnetic Resonance Imaging
  • Subarachnoid Hemorrhage*