Which physical findings are characteristic of cerebral amyloid angiopathy (CAA)?

Updated: Dec 19, 2018
  • Author: Ravi S Menon, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Physical findings in cerebral amyloid angiopathy (CAA) depend on the disease process associated with CAA in a particular patient.

The features of intracranial hemorrhage (ICH) depend on the location of the bleed. Strict isolation of features from each lobe is frequently not possible because of extension of hematoma to other lobes, mass effect, and increased intracranial pressure. Even so, location-related presentations can be characterized as follows:

  • Frontal - Depending on the size and location, frontal ICH may present with symptoms ranging from weakness of one limb to impaired consciousness with contralateral hemiparesis, hemisensory loss, and horizontal gaze palsy; left hemispheric lesions can present with aphasia, and more anterior lesions lead to an abulic state with frontal release signs

  • Parietal - Hemisensory loss, homonymous hemianopsia, hemi-inattention, and apraxia are all signs of parietal ICH

  • Temporal - Dominant-hemisphere hematomas lead to aphasia and hemianopia; nondominant hemisphere hematomas produce a confusional state

  • Occipital - Unilateral hemianopia or quadrantanopia and visual hallucinations often accompany occipital ICH

Coma at presentation has been reported in a small proportion of patients (0.4-19%) with ICH. A decreased level of consciousness, related to the size and location of the hematoma, results from compression of the contralateral hemisphere or brainstem or from increased intracranial pressure.

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