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October 2017; 7 (5) Case

Focal cerebral β-amyloid angiopathy

A distinct clinicopathologic presentation

Elissaios Karageorgiou, Georges Naasan, Samuel J. Pleasure, Sanda Alexandrescu, Jeffrey M. Gelfand, Gautam Tammewar, Bruce L. Miller, Gil D. Rabinovici, Lea T. Grinberg
First published March 24, 2017, DOI: https://doi.org/10.1212/CPJ.0000000000000354
Elissaios Karageorgiou
Memory and Aging Center (EK, GN, GT, BLM, GDR, LTG) and Multiple Sclerosis and Neuroinflammation Center (SJP, JMG), Department of Neurology, and Department of Pathology and Laboratory Medicine (SA), University of California San Francisco; Neurological Institute of Athens (EK), Greece; and Department of Pathology (LTG), University of São Paulo Medical School, Brazil. S.A. is currently affiliated with Boston Children's Hospital, MA.
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Georges Naasan
Memory and Aging Center (EK, GN, GT, BLM, GDR, LTG) and Multiple Sclerosis and Neuroinflammation Center (SJP, JMG), Department of Neurology, and Department of Pathology and Laboratory Medicine (SA), University of California San Francisco; Neurological Institute of Athens (EK), Greece; and Department of Pathology (LTG), University of São Paulo Medical School, Brazil. S.A. is currently affiliated with Boston Children's Hospital, MA.
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Samuel J. Pleasure
Memory and Aging Center (EK, GN, GT, BLM, GDR, LTG) and Multiple Sclerosis and Neuroinflammation Center (SJP, JMG), Department of Neurology, and Department of Pathology and Laboratory Medicine (SA), University of California San Francisco; Neurological Institute of Athens (EK), Greece; and Department of Pathology (LTG), University of São Paulo Medical School, Brazil. S.A. is currently affiliated with Boston Children's Hospital, MA.
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Sanda Alexandrescu
Memory and Aging Center (EK, GN, GT, BLM, GDR, LTG) and Multiple Sclerosis and Neuroinflammation Center (SJP, JMG), Department of Neurology, and Department of Pathology and Laboratory Medicine (SA), University of California San Francisco; Neurological Institute of Athens (EK), Greece; and Department of Pathology (LTG), University of São Paulo Medical School, Brazil. S.A. is currently affiliated with Boston Children's Hospital, MA.
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Jeffrey M. Gelfand
Memory and Aging Center (EK, GN, GT, BLM, GDR, LTG) and Multiple Sclerosis and Neuroinflammation Center (SJP, JMG), Department of Neurology, and Department of Pathology and Laboratory Medicine (SA), University of California San Francisco; Neurological Institute of Athens (EK), Greece; and Department of Pathology (LTG), University of São Paulo Medical School, Brazil. S.A. is currently affiliated with Boston Children's Hospital, MA.
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Gautam Tammewar
Memory and Aging Center (EK, GN, GT, BLM, GDR, LTG) and Multiple Sclerosis and Neuroinflammation Center (SJP, JMG), Department of Neurology, and Department of Pathology and Laboratory Medicine (SA), University of California San Francisco; Neurological Institute of Athens (EK), Greece; and Department of Pathology (LTG), University of São Paulo Medical School, Brazil. S.A. is currently affiliated with Boston Children's Hospital, MA.
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Bruce L. Miller
Memory and Aging Center (EK, GN, GT, BLM, GDR, LTG) and Multiple Sclerosis and Neuroinflammation Center (SJP, JMG), Department of Neurology, and Department of Pathology and Laboratory Medicine (SA), University of California San Francisco; Neurological Institute of Athens (EK), Greece; and Department of Pathology (LTG), University of São Paulo Medical School, Brazil. S.A. is currently affiliated with Boston Children's Hospital, MA.
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Gil D. Rabinovici
Memory and Aging Center (EK, GN, GT, BLM, GDR, LTG) and Multiple Sclerosis and Neuroinflammation Center (SJP, JMG), Department of Neurology, and Department of Pathology and Laboratory Medicine (SA), University of California San Francisco; Neurological Institute of Athens (EK), Greece; and Department of Pathology (LTG), University of São Paulo Medical School, Brazil. S.A. is currently affiliated with Boston Children's Hospital, MA.
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Lea T. Grinberg
Memory and Aging Center (EK, GN, GT, BLM, GDR, LTG) and Multiple Sclerosis and Neuroinflammation Center (SJP, JMG), Department of Neurology, and Department of Pathology and Laboratory Medicine (SA), University of California San Francisco; Neurological Institute of Athens (EK), Greece; and Department of Pathology (LTG), University of São Paulo Medical School, Brazil. S.A. is currently affiliated with Boston Children's Hospital, MA.
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Citation
Focal cerebral β-amyloid angiopathy
A distinct clinicopathologic presentation
Elissaios Karageorgiou, Georges Naasan, Samuel J. Pleasure, Sanda Alexandrescu, Jeffrey M. Gelfand, Gautam Tammewar, Bruce L. Miller, Gil D. Rabinovici, Lea T. Grinberg
Neurol Clin Pract Oct 2017, 7 (5) 444-448; DOI: 10.1212/CPJ.0000000000000354

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We report on a 70-year-old right-handed woman who presented with an 11-year history of a gradually progressive motor and cognitive-behavioral syndrome caused by focal cerebral β-amyloid angiopathy manifesting as discrete mass lesions. At age 59, she developed left leg clumsiness and cramping, evolving within a year into leg stiffness. Similar symptoms gradually affected her left arm. At age 65, she noted progressive word-finding difficulties, anxiety, mental rigidity, and compulsive traits. By age 68, she had difficulties with processing speed, planning, and navigation. Her history was notable for mild hypertension, hyperlipidemia, hypothyroidism, sleep apnea, bilateral carpal tunnel syndrome, and uterine fibroids; her mother had late-onset parkinsonism. She never smoked or used illicit drugs.

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  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • Received December 9, 2016.
  • Accepted February 3, 2017.
  • © 2017 American Academy of Neurology
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