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30 - Cerebral Amyloid Angiopathy (CAA)

Should It Be a Contraindication for Drugs Like Lecanemab?

Published online by Cambridge University Press:  19 January 2024

Daniel Gibbs
Affiliation:
Emeritus of Oregon Health and Science University
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Summary

CAA is vascular disease of the brain in which beta-amyloid is deposited in the walls of small arteries and capillaries. The amyloid replaces smooth muscle cells, causing vessel wall thickening and stiffness. This can result in leaks and reduced blood flow in these small blood vessels. Tiny hemorrhages and small strokes are seen surrounding the affected blood vessels. In the elderly, CAA is a major cause of serious bleeding in the various lobes of the brain. Genetically, it can occur sporadically or in families. There is often but not always an overlap with Alzheimer’s disease.

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Publisher: Cambridge University Press
Print publication year: 2024

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References

Viswanathan, A, Greenberg, SM. Cerebral amyloid angiopathy in the elderly. Ann Neurol 2011; 70: 871880. https://doi.org/10.1002/ana.22516 (open access).CrossRefGoogle ScholarPubMed
Chokesuwattanaskul, A, Zotin, MCZ, Schoemaker, D, et al. Apathy in patients with cerebral amyloid angiopathy: A multimodal neuroimaging study. Neurology 2023 (published online ahead of print on March 20, 2023). https://doi.org/10.1212/WNL.0000000000207200.CrossRefGoogle Scholar
Kozberg, MG, Perosa, V, Gurol, ME, van Veluw, SJ. A practical approach to the management of cerebral amyloid angiopathy. Int J Stroke 2021; 16: 356369. https://doi.org/10.1177/1747493020974464 (open access).CrossRefGoogle Scholar
Rosand, J, Hylek, EM, O’Donnell, HC, Greenberg, SM. Warfarin-associated hemorrhage and cerebral amyloid angiopathy: A genetic and pathologic study. Neurology 2000; 55: 947951. https://doi.org/10.1212/wnl.55.7.947. PMID: 11061249.CrossRefGoogle ScholarPubMed
Reish, NJ, Jamshidi, P, Stamm, B, et al. Multiple cerebral hemorrhages in a patient receiving lecanemab and treated with t-PA for stroke. N Engl J Med 2023; 388: 478. https://doi.org/10.1056/NEJMc2215148.CrossRefGoogle Scholar

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  • Cerebral Amyloid Angiopathy (CAA)
  • Daniel Gibbs, Emeritus of Oregon Health and Science University
  • Book: Dispatches from the Land of Alzheimer's
  • Online publication: 19 January 2024
  • Chapter DOI: https://doi.org/10.1017/9781009430067.031
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  • Cerebral Amyloid Angiopathy (CAA)
  • Daniel Gibbs, Emeritus of Oregon Health and Science University
  • Book: Dispatches from the Land of Alzheimer's
  • Online publication: 19 January 2024
  • Chapter DOI: https://doi.org/10.1017/9781009430067.031
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Cerebral Amyloid Angiopathy (CAA)
  • Daniel Gibbs, Emeritus of Oregon Health and Science University
  • Book: Dispatches from the Land of Alzheimer's
  • Online publication: 19 January 2024
  • Chapter DOI: https://doi.org/10.1017/9781009430067.031
Available formats
×