Cerebral amyloid angioplasty or CAA pertains to the deposition of B-amyloid in the arteries and veins of the cerebral cortex. It is considered a disorder where amyloid is deposited in the brain. It should not be associated or confused with systemic amyloidosis. Cerebral Amyloid Angiopathy or CAA has been identified as one of the main markers for Alzheimer’s Disease. But, the condition may also be found in patients who are old but are still mentally sound.
Cerebral Amyloid Angioplasty is usually asymptomatic meaning it will not present itself with any noticeable symptoms. It may, however, lead to dementia, intracranial hemorrhage (ICH), and transient neurologic events. Among the complications of Cerebral Amyloid Angioplasty or CAA, Intracranial Hemorrhage (ICH) is recognized as the most obvious result of Cerebral Amyloid Angioplasty.
How is Cerebral Amyloid Angiopathy or CAA diagnosed?
The Boston Cerebral Amyloid Angioplasty Group has identified certain guidelines to effectively diagnose and detect Cerebral Amyloid Angioplasty, particularly those that present with Intracranial Hemorrhage (ICH). The said medical group recommends four (4) levels of probability in diagnosing Cerebral Amyloid Angioplasty. These probabilities are possible, probable, probable with pathologic evidence, and definite. These four levels are described further as:
- Possible Cerebral Amyloid Angioplasty or CAA – This level is usually utilized if the patient is older than 60 years old. They have a Magnetic Resonance Imaging (MRI) showing a single hemorrhage without any other cause or multiple hemorrhages without any definite cause.
- Probable Cerebral Amyloid Angioplasty or CAA – This level of probability is usually applied to patients with findings showing multiple hematomas. This applies to patients that are older than 60 years of age.
- Probable Cerebral Amyloid Angioplasty or CAA with Pathologic Evidence – This level of Cerebral Amyloid Angioplasty probability shows the patient with hemorrhage with some confirmed amyloid deposition.
- Definite Cerebral Amyloid Angioplasty or CAA – This level of probability for Cerebral Amyloid Angioplasty shows full postmortem with hemorrhage and signs of severe Cerebral Amyloid Angioplasty.
How Does Cerebral Amyloid Angiopathy Develop?
A lot of cases of Cerebral Amyloid Angioplasty are random and sporadic. However, there are other risk factors to consider in the development of this disorder. Some patients with the genetic predisposition to develop Cerebral Amyloid Angioplasty may have a different risk level than other patients without any genetic predisposition for the aforementioned disorder. A large amount of Cerebral Amyloid Angioplasty with Intracranial Hemorrhage (ICH) occurs spontaneously. Amyloid deposition is an intricate and complex process. It involves the production of amyloid precursor proteins (APP), processing of precursor proteins, aggregation of the protein, and lastly, fibril formation. Experts believe that impaired processing of amyloids which may explain the link between Cerebral Amyloid Angioplasty (CAA) and Alzheimer’s Disease (AD).
Physical Examination for Patients with Cerebral Amyloid Angiopathy
Health professionals perform Cerebral Amyloid Angioplasty physical examinations on patients based on associated findings and the processes associated with Cerebral Amyloid Angioplasty. It has been observed that Intracranial Hemorrhage (ICH) greatly depends on the location of the identified bleed. However, doctors and medical professionals should not discount the fact that while Intracranial Hemorrhage (ICH) may be located based on the location of bleeding, there are possible intrusions within the other lobes of the brain. And as such, should not be verified as an isolated bleed. Rather, as a possible combination of location and bleeding extension. Still, there are location-based presentations for Cerebral Amyloid Angioplasty or CAA that may be used to help further address this disorder. Listed below are some of these location-based presentations:
- Frontal Intracranial Hemorrhage (ICH) – This location for Intracranial Hemorrhage (ICH) may result in and present symptoms such as weakness of a limb. It also presents issues with a patient’s consciousness with collateral hemiparesis, hemisensory loss, and horizontal gaze palsy. Lesions can also present with aphasia and can lead to an abulic state.
- Parietal Intracranial Hemorrhage (ICH) – Symptoms of the parietal location of bleeding include hemisensory loss, homonymous hemianopsia, and apraxia.
- Temporal Intracranial Hemorrhage (ICH) – Temporal location of Intracranial Hemorrhage (ICH) may present symptoms such as aphasia and hemianopia and may result in a confused state for patients.
- Occipital Intracranial Hemorrhage (ICH) – Occipital Intracranial Hemorrhage (ICH) may have symptoms similar to the temporal location of Hemorrhage (ICH) which presents hallucinations, confusion, and unilateral hemianopia.
How to Avoid Intracranial Hemorrhage (ICH) caused by Cerebral Amyloid Angiopathy Develop?
Individuals suffering from Cerebral Amyloid Angioplasty (CAA) may have to avoid warfarin. This is because it may increase the risk of bleeding. On the other hand, patients with coronary artery disease, cardiac stents, and or ischemic stroke must have a more tailored and customized management plan. The advantages of antithrombotic therapy are obvious, the decrease in antiplatelet therapy may have a different or even adverse effect.
Patients with hypertension or high blood pressure may also be addressed first to help alleviate the symptoms of Intracranial Hemorrhage (ICH) caused by Cerebral Amyloid Angioplasty. Evidence suggests that those patients treated for hypertension have a lower risk of developing hemorrhage. This is compared to those whose high blood pressure or hypertension is left untreated.
Another study also showed that the lack of control or management of high blood pressure resulted in a higher risk of developing lobar and nonlabor Intracranial Hemorrhage (ICH) caused by Cerebral Amyloid Angioplasty. Liver transplantation is also another option that may be explored by both the health professional and the patient. It is because it has lowered the risk of developing a hemorrhage. Patients who also underwent transplantation experienced a lower risk of developing dementia. No physical activity is restricted for people with Intracranial Hemorrhage (ICH) caused by Cerebral Amyloid Angioplasty. But it is recommended that patients avoid any form of head trauma. This is to prevent it to worsen and negatively affect the patients existing condition.
Intracranial Hemorrhage (ICH) caused by Cerebral Amyloid Angioplasty may seem like a daunting disorder or health condition. However, proper coordination and collaboration with a medical professional can help the patient achieve better health outcomes and overall wellness. Treatments are available to address CAA and ICH but prevention should also be one of the primary goals of patients.