CEREBRAL AMYLOID ANGIOPATHY - PROSPECTS FOR CLINICAL-DIAGNOSIS AND TREATMENT

This article reviews diagnosis of cerebral amyloid angiopathy (CAA) du ring life and possible approaches to prevention. A clinical diagnosis of ''probable CAA'' can be made in patients aged 60 years or older wit h multiple hemorrhages confined to lobar brain regions and no other ca use of hemorrhage. Gradient-echo MRI facilitates diagnosis by showing previous hemorrhages with high sensitivity. This technique can also ma rk the progression of CAA, as 50% of studied patients developed new pe techial hemorrhages during 1.5 years of follow-up. The apolipoprotein E epsilon 2 and epsilon 4 alleles are associated with increased risk. and earlier age of first hemorrhage, but are neither sensitive nor spe cific for CAA. The major remaining challenges are to develop new marke rs for the presence of CAA and treatments to block vascular amyloid de position and vessel breakdown.