Cerebral Amyloid Angiopathy Symptoms: Let's talk about it.

Symptoms may not look like a stroke My husband woke up one morning feeling a bit dizzy when he got out of bed. He started to vomit soon after and couldn’t keep anything down all day. I assumed that he had some sort of gastro. The vomiting continued and I was concerned that he was becoming dehydrated. So, I took him to hospital. Much to my surprise the A & E doctor, after examining him, was doubtful that it was gastro-intestinal in nature and was of the opinion that he’d had another stroke. The CT scan showed nothing and he was kept in hospital over night, given some anti-nausea medication and hydration, and discharged the next day to have an MRI a few days later. The MRI (his first one for a couple of years), revealed that he’d had a stroke in his Cerebellum (hence the vomiting and reduction in balance) and a further six recent strokes in addition to many more microbleeds since his last MRI. The radiologist was somewhat perplexed given the number of bleeds and it took him a long ...

  What I have learnt about CAA The small micro bleeds that are part of CAA are often present in the brain before they cause any noticeable symptoms.   These microbleeds are generally only able to be identified by an MRI scan. A CT scan will only pick up larger bleeds or strokes. The amyloid plaques are not in the cerebral tissue (as in Alzheimer's Disease) but are located within the blood vessels in the brain. This makes the blood vessels more fragile and prone to bleeding (haemorrhagic strokes). Most information does not tell you that these plaques can also lead to blockage of the blood vessels (ischaemic strokes). There is no known cause (although there are current numerous studies into this) and there is no cure and there is no treatment. The only "treatment" is to ensure that the person's blood pressure remains well managed. The person will generally be advised to avoid taking any medication that is a blood thinner eg aspirin, ibuprofen, naproxen. The amyloid p...

MRI and Cerebral Amyloid Angiopathy While my husband was in the Stroke Unit they were able to compare his MRI results to those taken two years earlier. It showed a substantial increase in the number of microbleeds throughout his brain in the last two years, all of which had been apparently asymptomatic. Of course this raises the question of how can you have a stroke and not know about it? In CAA it is common for microbleeds to occur without the person or their loved ones being aware of it. It's only when you do an MRI that you can see them. They generally don't show up in a regular CT scan. The image above shows a typical MRI of a person with CAA. So what is your approach and that of your medical practitioners into the future? Given that there is no known cause, no treatment and no cure, do you really want to have 6 monthly or annual scans to prove the deterioration of the condition? What purpose does that serve? We decided, in conjunction with his specialist, that there was li...

  The "Triple Whammy" of CAA No known cause, no cure and no treatment (except ensuring blood pressure is well controlled) Amyloid plaqes that are present in the brain in dementia, instead build up in the blood vessels of the brain. This results in either the plaques blocking the brain (causing ischaemic strokes) or makes the blood vessels more fragile causing haemorrhagic strokes). This is the double whammy. There is so much research and improvements in treatment for ischaemic strokes including “clot busting” drugs, but these cannot be used for someone with CAA. The triple whammy is that the person also has multiple “micro bleeds” which are generally asymptomatic, and often you won’t be aware of them unless you have an MRI scan.   These microbleeds lead to a background of ongoing cognitive impairment which mimics progressive dementia.        Finally, the other risk is that you don’t know when the next major stroke will be. You just know that i...