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Advanced Neurology

CASE REPORT
Cerebral amyloid angiopathy-related inflammation:

A case report and literature review

Yue Zhang, Jian-zhong Fu, Xiao-lei Deng, Yue Chen, Zhong Zhao*, and Chen-
hong Qiu*
Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou,
Jiangsu, China

Abstract

Cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease caused by the
deposition of beta-amyloid in the small- and medium-sized blood vessels of the
cerebral cortex and leptomeninges, leading to intracranial vascular amyloidosis.
Herein, we report a case of CAA -related inflammation (CAA-ri), a rare clinical
condition, focusing on the clinical manifestations, imaging characteristics,
cerebrospinal fluid (CSF) findings, and treatment strategies. Key clinical manifestations
included psychiatric abnormalities, cognitive impairment, and epilepsy. Brain
magnetic resonance imaging revealed asymmetric white matter lesions, whereas
susceptibility-weighted imaging demonstrated multiple microbleeds. CSF analysis
indicated elevated total protein levels. Following corticosteroid pulse therapy, there
*Corresponding authors: was a marked improvement in both clinical symptoms and imaging findings. Given
Chen-hong Qiu its rarity in clinical practice, early recognition and timely intervention of CAA-ri are
(qiuchenhong8@163.com) crucial for optimizing patient outcomes and enhancing quality of life.
Zhong Zhao
(zhaozhong1963@sina.com)
Citation: Zhang Y, Fu J, Deng X, Keywords: Cerebral amyloid angiopathy-related inflammation; White matter
Chen Y, Zhao Z, Qiu C. Cerebral degeneration; Multiple microbleeds; Diagnosis; Misdiagnosis
amyloid angiopathy-related
inflammation: A case report and
literature review. Adv Neurol.
2025;4(4):106-111.
doi: 10.36922/AN025080015 1. Introduction
Received: February 20, 2025 Cerebral amyloid angiopathy (CAA) is a common cerebral small vessel disease in the
Revised: May 12, 2025 elderly, caused by the deposition of beta-amyloid (Aβ) in the small and medium-sized
Accepted: May 22, 2025 blood vessels of the cerebral cortex and leptomeninges, leading to intracranial vascular
amyloidosis. CAA-related inflammation (CAA-ri) is a rare and treatable clinical subtype
Published online: June 25, 2025 of CAA, which is considered to be related to Aβ deposition and immune inflammation.
1
Copyright: © 2025 Author(s). Unlike typical CAA, CAA-ri is marked by extensive cortical and subcortical microbleeds,
This is an Open-Access article and its progression can be effectively managed with immunosuppressive therapy. Given
2
distributed under the terms of the
Creative Commons Attribution its atypical symptoms, CAA-ri is extremely easy to overlook clinically. Here, we report
License, permitting distribution, patients with diverse clinical manifestations of CAA-ri and review relevant literature to
and reproduction in any medium,
provided the original work is deepen clinicians’ understanding of this disease and reduce misdiagnosis and missed
properly cited. diagnosis.
Publisher’s Note: AccScience
Publishing remains neutral with 2. Case presentation
regard to jurisdictional claims in
published maps and institutional A 73-year-old male presented to the Department of Neurology, Suzhou Hospital Affiliated
affiliations. to Nanjing Medical University on July 15, 2023, due to “unsteady walking accompanied

Volume 4 Issue 4 (2025) 106 doi: 10.36922/AN025080015