Reversible acute leukoencephalopathy as a form of presentation in cerebral amyloid angiopathy

Abstract 

Background

Cerebral amyloid angiopathy (CAA) may present as cerebral haemorrhage, cerebral infarction and periventricular white matter lesions. Reversible leukoencephalopathy is a rare manifestation of CAA.

Aims of the study

To describe two patients with reversible acute leukoencephalopathy as the first manifestation of CAA.

Patients

Two consecutive patients were admitted to our neurology department with transient focal neurological symptoms. They showed reversible focal leukoencephalopathy on magnetic resonance imaging (MRI). CAA was finally diagnosed in both, and pathologically confirmed in one. The latter patient showed multiple foci of petechial bleeding in the cortex and subcortex in T2-weighted GRE sequences, suggestive of CAA.

Conclusion

Reversible acute focal leukoencephalopathy may be an infrequent clinical and radiological pattern of CAA.

Keywords: Cerebral amyloid angiopathy, Cerebral haemorrhage, Leukoencephalopathy, MRI