Angiopatia amilóide cerebral simulando tumor cerebral: relato de caso <span class="so-article-trans-title" dir="auto"> Translated title: Cerebral amyloid angiopathy presenting as a brain tumor: case report </span>

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Abstract

Descrevemos o raro caso de um paciente de 45 anos portador de lesão expansiva intracraniana por angiopatia amilóide cerebral com características clínicas e de imagem compatíveis com um glioma de baixo grau. A biópsia revelou angiopatia amilóide cerebral. Os achados clínicos, radiológicos e histopatológicos são discutidos e analisados juntamente à literatura disponível.

Translated abstract

We describe the unusual case of a 45-year-old male patient harboring an intracranial mass due to cerebral amyloid angiopathy whose clinical and radiological features were those of a low grade glioma. Biopsy revealed cerebral amyloid angiopathy. The clinical, radiological and pathological findings are discussed as we review the available literature.

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Most cited references 17

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Spontaneous intracerebral hemorrhage: a review.

M Fewel, Søren T. Hoff, B Taylor Thompson (2003)

Spontaneous intracerebral hemorrhage (SICH) is a blood clot that arises in the brain parenchyma in the absence of trauma or surgery. This entity accounts for 10 to 15% of all strokes and is associated with a higher mortality rate than either ischemic stroke or subarachnoid hemorrhage. Common causes include hypertension, amyloid angiopathy, coagulopathy, vascular anomalies, tumors, and various drugs. Hypertension, however, remains the single greatest modifiable risk factor for SICH. Computerized tomography scanning is the initial diagnostic modality of choice in SICH, and angiography should be considered in all cases except those involving older patients with preexisting hypertension in thalamic, putaminal, or cerebellar hemorrhage. Medical management includes venous thrombosis prophylaxis, gastric cytoprotection, and aggressive rehabilitation. Anticonvulsant agents should be prescribed in supratentorial SICH, whereas the management of hypertension is controversial. To date, nine prospective randomized controlled studies have been conducted to compare surgical and medical management of SICH. Although definitive evidence favoring surgical intervention is lacking, there is good theoretical rationale for early surgical intervention. Surgery should be considered in patients with moderate to large lobar or basal ganglia hemorrhages and those suffering progressive neurological deterioration. Elderly patients in whom the Glasgow Coma Scale score is less than 5, those with brainstem hemorrhages, and those with small hemorrhages do not typically benefit from surgery. Patients with cerebellar hemorrhages larger than 3 cm, those with brainstem compression and hydrocephalus, or those exhibiting neurological deterioration should undergo surgical evacuation of the clot. It is hoped that the forthcoming results of the International Surgical Trial in IntraCerebral Hemorrhage will help formulate evidence-based recommendations regarding the role of surgery in SICH.

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Computer-assisted three-dimensional image analysis of cerebral amyloid angiopathy.

A Maeda, M. Yamada, Y Itoh … (1993)

Microaneurysms and fibrinoid necrosis of cerebral cortical arteries have been reported to be related to the pathogenesis of intracerebral hemorrhage associated with cerebral amyloid angiopathy. To elucidate the pathogenesis of such vascular lesions, we conducted the present study.

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CT and MR imaging of intracerebral amyloidoma: case report and review of the literature.

R Wee, Dheeraj Gandhi, Mayank Goyal (2003)

Intracerebral amyloidoma is the least common form of amyloid deposition in the brain. CT and MR imaging features in a case of pathologically proved cerebral amyloidoma are presented, and the available literature is reviewed. Typical imaging features of this entity include solitary or multiple supratentorial white matter masses that are hyperattenuated on nonenhanced CT. They have little or no mass effect on surrounding structures, extend medially up to the lateral ventricle wall, and have fine, irregular, enhancing margins.

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Author and article information

Journal

Journal ID (publisher-id): anp

Title: Arquivos de Neuro-Psiquiatria

Abbreviated Title: Arq. Neuro-Psiquiatr.

Publisher: Academia Brasileira de Neurologia - ABNEURO (São Paulo, SP, Brazil )

ISSN (Print): 0004-282X

ISSN (Electronic): 1678-4227

Publication date (Print and electronic): March 2006

Volume: 64

Issue: 1

Pages: 153-156

Affiliations

[01] Belo Horizonte MG orgnameHospital Madre Teresa orgdiv1Serviço de Neurocirurgia Brasil

[02] Belo Horizonte MG orgnameUniversidade Federal de Minas Gerais orgdiv1Faculdade de Medicina orgdiv2Departamento de Anatomia Patológica e Medicina Legal Brasil