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Advanced Neurology CAA-related inflammatory case

similar imaging manifestations, but the patient’s condition titled “Comparative Study on the Application of Situation
improved after immunosuppressive treatment, which is Teaching and Bedside Teaching in Physical Examination
inconsistent with the characteristics of IVL, such as rapid Teaching of Neurology Department.”
disease progression and poor prognosis. Clinically, there
are CAA-ri patients presenting with stroke-like symptoms Conflict of interest
or epileptic seizures. These patients were only given The authors declare they have no competing interests.
cerebrovascular and inflammatory treatments, missing
the chance of receiving immunotherapy at an early stage, Author contributions
thereby leading to a decline in their quality of life and even Conceptualization: All authors
poor prognosis.
Investigation: Yue Zhang
CAA-ri is potentially treatable. Clinically, short- Writing – original draft: Yue Zhang
term high-dose glucocorticoid shock therapy is the first Writing – review & editing: Zhong Zhao, Chen-hong Qiu
choice. Baskaran et al. demonstrated sustained cognitive
12
improvement lasting over 24 months through a 5-day Ethics approval and consent to participate
high-dose methylprednisolone pulse therapy followed by Written informed consent was obtained from the patient
a long-term maintenance regimen. The therapeutic effect following his participation.
12
of glucocorticoids on CAA-ri is also demonstrated in this
patient. Glucocorticoid treatment can not only relieve Consent for publication
the patient’s clinical symptoms and improve imaging The patient consented to the publication of his data.
manifestations but also reduce the risk of recurrence.
Some research indicates that the recurrence rate of CAA-ri Availability of data
can also be reduced in patients who only receive short-
term corticosteroid treatment. For long-term treatment, Not applicable.
11
immunosuppressants such as azathioprine, methotrexate, Further disclosure
and mycophenolate mofetil can be added to reduce
th
the patient’s dependence on hormones. Experimental Part of the findings have been presented at the 26 Academic
13
glucocorticoid treatment can reduce the necessity of Conference on Neurology of Jiangsu Medical Association
brain biopsy for patients. The biopsy is only considered on December 28, 2023, at Xuzhou, Jiangsu, China.
when there is no significant improvement in patients after
3 weeks of corticosteroid treatment. 8 References
1. Yiyuan X, Rong W, Xin G, et al. Research on the pathological
4. Conclusion characteristics and mechanism of inflammation associated
At present, there are relatively few reports of CAA-ri with cerebral amyloid angiopathy. Chin J Geriatr Heart
in China. The incidence of this pathological condition Brain Vessels. 2022;24(7):775-777.
has been underestimated, and misdiagnosis is common doi: 10.3969/j.issn.1009-0126.2022.07.028
among the affected patients. Therefore, CAA-ri should be 2. Charidimou A. Cerebral amyloid angiopathy-related
considered for the elderly with symptoms such as cognitive inflammation spectrum disorders: Introduction of
impairment, headache, epileptic seizures, mental and a novel concept and diagnostic criteria. Ann Neurol.
behavioral abnormalities, and focal neurological damage, 2025;97(3):470-474.
if MRI shows multiple asymmetric leukoencephalopathy doi: 10.1002/ana.27162
and microhemorrhages. Further improvement of CSF
antibody and genetic testing can be carried out for early 3. Mandybur TI. Cerebral amyloid angiopathy: Possible
to
relationship
vasculitis.
rheumatoid
Neurology.
identification, diagnosis, and treatment, so as to improve 1979;29(10):1336-1340.
the quality of life of patients.
doi: 10.1212/wnl.29.10.1336
Acknowledgments 4. Wu JJ, Yao M, Ni J. Cerebral amyloid angiopathy-related
None. inflammation: Current status and future implications. Chin
Med J (Engl). 2021;134(6):646-654.
Funding doi: 10.1097/CM9.0000000000001427
This work was supported by an educational research 5. Theodorou A, Tsibonakis A, Pateras IS, et al. Multiple
project of Suzhou Municipal Hospital (Slyyjy202301) cerebral microinfarcts: An uncommon presentation of

Volume 4 Issue 4 (2025) 110 doi: 10.36922/AN025080015