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

  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...

In the arena of being a carer Over the years when I have found times to be tough, I go back to thinking of the quote "The Man in the Arena" but of course these days it would be good to re-title it as "The Person in the Arena". Theodore Roosevelt many years ago captured beautifully the courage of the person in the arena who "dares greatly", sometimes over and over again. Being "in the arena" is hard work. Sometimes you feel strong and can roll with the punches but at other times you feel like curling up in a corner of the arena and just taking a rest. Other times you may need to exit the arena temporarily or for a longer period but no one can ever say you didn't give it a crack and you can take pride in the fact that you were not one of those "cold and timid souls" who prefer to point the finger from the sidelines. What does this have to do with CAA? It's a tough job as a carer and tough as your role changes from th...

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...

  The first major stroke caused by CAA One night two years later, my husband was acting sort of strange. He was very quiet. Didn’t say a lot. I asked if he was Ok. I even asked if he was annoyed with me. He said no but didn’t say a lot else. He was due to go out that night to see a film with some friends which he did (driving half and hour there and half an hour back). When he returned home he seemed OK. The next day he just didn’t seem to be himself. Still quiet, said he had a bit of a headache and was tired but that he was OK. I had a funeral to attend some distance from home (I needed to go and there was not enough to make me think I should stay) but I just felt in my gut that something was not right. I rang him a couple of hours later, he was not making any sense in his speech and I could not understand what he was trying to tell me. He also sounded very confused. I immediately thought that he’d had a stroke, I called a family member who lived locally who went around to see ...

Too young to have a stroke? We spent the weekend trying to get our head around what had happened. How could this be? He was so young. These sorts of things don’t happen at our age but of course these sorts of things can happen at any age.  We met with the neurologist on the Monday and his whole approach put us more at ease and he was easily able to identify the source of my husband's  symptoms. A small Sub Arachnoid Haemorrhage on the outside of the left side of his brain was clear on the MRI. This type of bleed causes a blood clot to sit on the surface of the brain and as it resolves over time it becomes irritated and sets off some temporary symptoms. He told us that it should resolve in a few weeks. However, the multiple strokes (very minor) identified by the radiologist were present but the neurologist said that this was not uncommon in people of his age but that it could be a condition called Cerebral Amyloid Angiopathy. He was gentle with us, for which I am eternally grat...

  8% of older people in Australia live with Cerebral Amyloid Angiopathy My husband and I were relaxing after dinner one night a number of years ago, when all of a sudden he let out a yell and jumped up and told me that he had pins and needles in his R hand and that it was spreading up his arm to his face. Over the next few minutes it spread down his whole right side to his leg and foot. He had full movement. Ten minutes later it was gone. He was not yet 60. In hindsight, I don’t know why we didn’t go to a hospital straight away but we were on a holiday, somewhat isolated, sort of in a state of shock; and it all disappeared so quickly. Having worked as a health professional, you think of all the possibilities that it might be from some sort of neck or spinal problem (rule that out because the R side of his face had gone numb) and many other things including a stroke, but it all just disappeared as quickly as it came. It scared us though. We packed up our brief holiday break and ...