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Case 88 - Cerebralamyloid angiopathy-related intracranial hemorrhage

from Section II - Neurocritical care

Published online by Cambridge University Press:  03 May 2011

George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
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Summary

The most common risk factors associated with intracerebral hemorrhage (ICH) are hypertension and cerebral amyloid angiopathy (CAA). It is characterized by the deposition of beta-amyloid peptide into the media and adventitia of small arteries and capillaries. The beta-amyloid peptide is toxic to the vascular smooth muscle cells leading to damage to the blood vessel wall and consequent hemorrhage. The diagnosis is based on the Boston Criteria utilizing clinical data, autopsy, surgical pathology, or magnetic resonance imaging (MRI). Medical treatment of CAA-related ICH is based on control of the hemorrhage, management of blood pressure, management of elevated ICP, and treatment of seizures, fevers, and hyperglycemia. The management of CAA-related ICH is complex and close neurologic monitoring is essential. With the development of new potential biomarkers for the disease, we may begin to explore therapeutic options before patients develop ICH.
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Publisher: Cambridge University Press
Print publication year: 2011

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