Cerebral amyloid angiopathy: a pseudo-tumoral presentation in two spontaneously favorable cases

A rare clinical and radiographical presentation of cerebral amyloid angiopa thy mimicking a brain neoplasm was observed in 2 patients. The signs and sy mptoms included seizures and focal parieto-occipital dysfunction in I case, massive left hemisphere dysfunction and akinetic mutism in the other. Brai n CT and MRI showed nonspecific focal white matter abnormalities suggestive of the diagnosis of low-grade glioma. Gradient echo TI and T2-weighted ima ges showing multiple areas of signal void suggesting multiple disseminated petechial hemorrhages led to the diagnosis of cerebral amyloid angiopathy. An eventless brain biopsy confirmed the diagnosis. The neuropathology exami nation disclosed amyloid angiopathy of the pial and cortical vessels select ively stained by anti A-beta protein antibodies. The clinical course was re markable in the two cases with almost complete clinical recovery without an y particular treatment.