Senile cerebral amyloid angiopathy is a condition in which a protein known as amyloid is deposited into the walls of the blood vessels that supply blood to the brain.
It is not known why amyloid is deposited into the brain's blood vessel walls in senile cerebral amyloid angiopathy. The protein deposits weaken the blood vessels. This results in a greatly increased risk for bleeding into the brain, known as intracerebral hemorrhage. The bleeding may cause permanent brain damage or death.
Symptoms only exist if there is an intracerebral hemorrhage. This bleeding into the brain usually causes sudden symptoms, including: visual impairments, such as blindness or blurry visionloss of ability to talk or talking in a way that doesn't make senseloss of sensation on one side of the bodyweakness or paralysis on one side of the bodyheadacheseye pain or ear painconfusionnausea and vomitingdrowsinessstiff neckloss of consciousnessseizures, which are caused by abnormal electrical activity in the brain that may result in shaking or other symptoms
The exact cause of senile cerebral amyloid angiopathy is not known. Most cases occur in people older than 60 years.
There are no known ways to prevent senile cerebral amyloid angiopathy.
A healthcare professional may suspect senile cerebral amyloid angiopathy after the history and physical exam. Imaging studies of the brain, such as a cranial CT scan or cranial MRI, will show the bleeding into the brain.
However, there are other causes of bleeding into the brain, such as high blood pressure. Examining a piece of the person's brain with a microscope is the only way to diagnose this condition. This is usually only done after death, during an autopsy.
A person with senile cerebral amyloid angiopathy usually has repeated episodes of bleeding into the brain over a period of months or years. Each episode of bleeding carries a risk of death or permanent brain damage. After each episode of bleeding, a person usually becomes more and more disabled. The person may become totally dependent on others for his or her basic needs. Death will eventually occur.
Senile cerebral amyloid angiopathy is not known to be contagious or inherited.
There are no known treatments for senile amyloid angiopathy. However, treatment is needed when an intracerebral hemorrhage occurs. Treatment often involves the use of medications such as mannitol to reduce the pressure within the brain. An individual with large bleeding episodes may benefit from craniotomy, a surgery in which an opening is made through the skull to remove the blood in or around the brain.
Medications are also used to treat seizures if they occur. Other treatment depends on the type of brain damage or disability the person develops. For example, a person may need a device to help him or her walk, such as a cane or walker. Others may need around-the-clock nursing care to help them eat, bathe, and dress.
All medications have possible side effects. For example, mannitol can cause allergic reactions and salt imbalances. Surgery can be complicated by further bleeding, brain damage, infection, or reactions to anesthesia.
Treatment depends on the person's medical problems and disabilities after the bleeding episode. Because senile cerebral amyloid angiopathy cannot be diagnosed for certain before death and no treatment is available, further treatment is based on the person's current needs. The individual usually becomes gradually worse with each episode of bleeding.
The person, or his or her caregivers, should seek immediate medical attention if any of the symptoms of bleeding into the brain occur. Other monitoring is based on the person's needs and disabilities.
Harrison's Principles of Internal Medicine, 1998, Fauci et al.